Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis
Objective This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China. Methods A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing...
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| Veröffentlicht in: | Applied health economics and health policy 2023-05, Vol.21 (3), p.489-499 |
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| creator | Jiang, Yawen Jiang, Shan Li, Limin Shi, Si Li, Mincai Si, Lei |
| description | Objective
This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China.
Methods
A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing both treatment discontinuation and waning effects, the analysis aimed to evaluate the incremental cost-effectiveness ratio of denosumab compared to alendronate by simulating a cohort of previously fractured individuals over the residual lifetime from the healthcare system perspective. Hip, vertebral, and wrist/humeral fractures were tracked along with the associated medical costs and quality-adjusted life-years. Age-related health state utility values, health state utility values of fractures, costs, fracture incidence, and mortality risks for Chinese were used whenever available. Comparative effectiveness data were obtained from a published network meta-analysis. One-way and probabilistic sensitivity analyses were conducted.
Results
In the base case, denosumab was dominated by alendronate with incremental costs of CN¥2743 (US$425) and incremental health outcomes of − 0.20 quality-adjusted life-years at its current price in mainland China. It remained dominated in all one-way sensitivity analysis robustness checks. However, denosumab was cost effective if both drugs did not carry any waning effects. In the probabilistic sensitivity analysis, denosumab remained dominated in all replications.
Conclusions
Denosumab is not cost effective for preventing secondary fractures among overall postmenopausal women in China. It is advisable to identify alternative denosumab regimens for high-risk subgroups among previously fractured postmenopausal women. |
| doi_str_mv | 10.1007/s40258-022-00784-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2763333011</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2763333011</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-beade949059f3119b4daadc130e26fa0df2bd693ccbf6806222bf70c123b0b1e3</originalsourceid><addsrcrecordid>eNp9kc9qFTEUhwdRbK2-gAsJuHEzmj-T3Im7y22rhQstVHE5ZJKTmjKTXHMmhT6Nr2p6b1VwYTbJId_5TsivaV4z-p5RuvqAHeWybynnbS37rhVPmmPGVrplvVZP92fZSiX5UfMC8ZZSrpTunjdHQimuaMeOm5-bhAs58x7sEu4gAiJJnpxCTFhmMxKfMrkGm6Iz-Z5cZajQElJ8oC5xgbRLOS3BkvNs7FIyIFnPKd6Qqyqeq2ZnCpqJfEu1ICGSzfcQzUeyjuQiunAXXDFTu63aiVyHuUxmb19HM91jwJfNM28mhFeP-0nz9fzsy-Zzu738dLFZb1vb0X5pRzAOdKep1F4wpsfOGeMsExS48oY6z0entLB29KqninM--hW1jIuRjgzESfPu4N3l9KMALsMc0MI0mQip4MBXStRFGavo23_Q21RyfW-leiplryWTleIHyuaEmMEPuxzm-ocDo8NDfMMhvqHGN-zjG0RtevOoLuMM7k_L77wqIA4A1qt4A_nv7P9ofwHWi6iV</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2805589515</pqid></control><display><type>article</type><title>Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis</title><source>MEDLINE</source><source>PAIS Index</source><source>SpringerLink Journals - AutoHoldings</source><creator>Jiang, Yawen ; Jiang, Shan ; Li, Limin ; Shi, Si ; Li, Mincai ; Si, Lei</creator><creatorcontrib>Jiang, Yawen ; Jiang, Shan ; Li, Limin ; Shi, Si ; Li, Mincai ; Si, Lei</creatorcontrib><description>Objective
This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China.
Methods
A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing both treatment discontinuation and waning effects, the analysis aimed to evaluate the incremental cost-effectiveness ratio of denosumab compared to alendronate by simulating a cohort of previously fractured individuals over the residual lifetime from the healthcare system perspective. Hip, vertebral, and wrist/humeral fractures were tracked along with the associated medical costs and quality-adjusted life-years. Age-related health state utility values, health state utility values of fractures, costs, fracture incidence, and mortality risks for Chinese were used whenever available. Comparative effectiveness data were obtained from a published network meta-analysis. One-way and probabilistic sensitivity analyses were conducted.
Results
In the base case, denosumab was dominated by alendronate with incremental costs of CN¥2743 (US$425) and incremental health outcomes of − 0.20 quality-adjusted life-years at its current price in mainland China. It remained dominated in all one-way sensitivity analysis robustness checks. However, denosumab was cost effective if both drugs did not carry any waning effects. In the probabilistic sensitivity analysis, denosumab remained dominated in all replications.
Conclusions
Denosumab is not cost effective for preventing secondary fractures among overall postmenopausal women in China. It is advisable to identify alternative denosumab regimens for high-risk subgroups among previously fractured postmenopausal women.</description><identifier>ISSN: 1175-5652</identifier><identifier>ISSN: 1179-1896</identifier><identifier>EISSN: 1179-1896</identifier><identifier>DOI: 10.1007/s40258-022-00784-3</identifier><identifier>PMID: 36626041</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Age groups ; Alendronate - therapeutic use ; Antibodies, Monoclonal, Humanized ; Bisphosphonates ; Bone Density Conservation Agents - therapeutic use ; Breast cancer ; Cancer therapies ; Cost analysis ; Cost-Benefit Analysis ; Cost-Effectiveness Analysis ; Denosumab - therapeutic use ; Effectiveness ; Female ; Fractures ; Health Administration ; Health care expenditures ; Health Economics ; Health risks ; Hip joint ; Humans ; Medicine ; Medicine & Public Health ; Meta-Analysis as Topic ; Monoclonal antibodies ; Mortality ; Mortality risk ; Network Meta-Analysis ; Oral administration ; Original Research Article ; Osteoporosis ; Osteoporosis, Postmenopausal - complications ; Osteoporosis, Postmenopausal - drug therapy ; Osteoporosis, Postmenopausal - prevention & control ; Osteoporotic Fractures - epidemiology ; Osteoporotic Fractures - prevention & control ; Pharmacoeconomics and Health Outcomes ; Postmenopause ; Prevention ; Public Health ; Quality of care ; Quality of Life Research ; Quality-Adjusted Life Years ; Reimbursement ; Secondary Prevention ; Sensitivity analysis ; Simulation ; Simulation analysis ; Women ; Womens health</subject><ispartof>Applied health economics and health policy, 2023-05, Vol.21 (3), p.489-499</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. May 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-beade949059f3119b4daadc130e26fa0df2bd693ccbf6806222bf70c123b0b1e3</citedby><cites>FETCH-LOGICAL-c408t-beade949059f3119b4daadc130e26fa0df2bd693ccbf6806222bf70c123b0b1e3</cites><orcidid>0000-0002-3044-170X ; 0000-0002-0498-0662</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40258-022-00784-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40258-022-00784-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27843,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36626041$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiang, Yawen</creatorcontrib><creatorcontrib>Jiang, Shan</creatorcontrib><creatorcontrib>Li, Limin</creatorcontrib><creatorcontrib>Shi, Si</creatorcontrib><creatorcontrib>Li, Mincai</creatorcontrib><creatorcontrib>Si, Lei</creatorcontrib><title>Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis</title><title>Applied health economics and health policy</title><addtitle>Appl Health Econ Health Policy</addtitle><addtitle>Appl Health Econ Health Policy</addtitle><description>Objective
This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China.
Methods
A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing both treatment discontinuation and waning effects, the analysis aimed to evaluate the incremental cost-effectiveness ratio of denosumab compared to alendronate by simulating a cohort of previously fractured individuals over the residual lifetime from the healthcare system perspective. Hip, vertebral, and wrist/humeral fractures were tracked along with the associated medical costs and quality-adjusted life-years. Age-related health state utility values, health state utility values of fractures, costs, fracture incidence, and mortality risks for Chinese were used whenever available. Comparative effectiveness data were obtained from a published network meta-analysis. One-way and probabilistic sensitivity analyses were conducted.
Results
In the base case, denosumab was dominated by alendronate with incremental costs of CN¥2743 (US$425) and incremental health outcomes of − 0.20 quality-adjusted life-years at its current price in mainland China. It remained dominated in all one-way sensitivity analysis robustness checks. However, denosumab was cost effective if both drugs did not carry any waning effects. In the probabilistic sensitivity analysis, denosumab remained dominated in all replications.
Conclusions
Denosumab is not cost effective for preventing secondary fractures among overall postmenopausal women in China. It is advisable to identify alternative denosumab regimens for high-risk subgroups among previously fractured postmenopausal women.</description><subject>Age groups</subject><subject>Alendronate - therapeutic use</subject><subject>Antibodies, Monoclonal, Humanized</subject><subject>Bisphosphonates</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>Breast cancer</subject><subject>Cancer therapies</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-Effectiveness Analysis</subject><subject>Denosumab - therapeutic use</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Fractures</subject><subject>Health Administration</subject><subject>Health care expenditures</subject><subject>Health Economics</subject><subject>Health risks</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-Analysis as Topic</subject><subject>Monoclonal antibodies</subject><subject>Mortality</subject><subject>Mortality risk</subject><subject>Network Meta-Analysis</subject><subject>Oral administration</subject><subject>Original Research Article</subject><subject>Osteoporosis</subject><subject>Osteoporosis, Postmenopausal - complications</subject><subject>Osteoporosis, Postmenopausal - drug therapy</subject><subject>Osteoporosis, Postmenopausal - prevention & control</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Osteoporotic Fractures - prevention & control</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Postmenopause</subject><subject>Prevention</subject><subject>Public Health</subject><subject>Quality of care</subject><subject>Quality of Life Research</subject><subject>Quality-Adjusted Life Years</subject><subject>Reimbursement</subject><subject>Secondary Prevention</subject><subject>Sensitivity analysis</subject><subject>Simulation</subject><subject>Simulation analysis</subject><subject>Women</subject><subject>Womens health</subject><issn>1175-5652</issn><issn>1179-1896</issn><issn>1179-1896</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc9qFTEUhwdRbK2-gAsJuHEzmj-T3Im7y22rhQstVHE5ZJKTmjKTXHMmhT6Nr2p6b1VwYTbJId_5TsivaV4z-p5RuvqAHeWybynnbS37rhVPmmPGVrplvVZP92fZSiX5UfMC8ZZSrpTunjdHQimuaMeOm5-bhAs58x7sEu4gAiJJnpxCTFhmMxKfMrkGm6Iz-Z5cZajQElJ8oC5xgbRLOS3BkvNs7FIyIFnPKd6Qqyqeq2ZnCpqJfEu1ICGSzfcQzUeyjuQiunAXXDFTu63aiVyHuUxmb19HM91jwJfNM28mhFeP-0nz9fzsy-Zzu738dLFZb1vb0X5pRzAOdKep1F4wpsfOGeMsExS48oY6z0entLB29KqninM--hW1jIuRjgzESfPu4N3l9KMALsMc0MI0mQip4MBXStRFGavo23_Q21RyfW-leiplryWTleIHyuaEmMEPuxzm-ocDo8NDfMMhvqHGN-zjG0RtevOoLuMM7k_L77wqIA4A1qt4A_nv7P9ofwHWi6iV</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>Jiang, Yawen</creator><creator>Jiang, Shan</creator><creator>Li, Limin</creator><creator>Shi, Si</creator><creator>Li, Mincai</creator><creator>Si, Lei</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>4T-</scope><scope>7TQ</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DHY</scope><scope>DON</scope><scope>DPSOV</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>KC-</scope><scope>L.-</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2L</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3044-170X</orcidid><orcidid>https://orcid.org/0000-0002-0498-0662</orcidid></search><sort><creationdate>20230501</creationdate><title>Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis</title><author>Jiang, Yawen ; Jiang, Shan ; Li, Limin ; Shi, Si ; Li, Mincai ; Si, Lei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-beade949059f3119b4daadc130e26fa0df2bd693ccbf6806222bf70c123b0b1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age groups</topic><topic>Alendronate - therapeutic use</topic><topic>Antibodies, Monoclonal, Humanized</topic><topic>Bisphosphonates</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>Breast cancer</topic><topic>Cancer therapies</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>Cost-Effectiveness Analysis</topic><topic>Denosumab - therapeutic use</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Fractures</topic><topic>Health Administration</topic><topic>Health care expenditures</topic><topic>Health Economics</topic><topic>Health risks</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-Analysis as Topic</topic><topic>Monoclonal antibodies</topic><topic>Mortality</topic><topic>Mortality risk</topic><topic>Network Meta-Analysis</topic><topic>Oral administration</topic><topic>Original Research Article</topic><topic>Osteoporosis</topic><topic>Osteoporosis, Postmenopausal - complications</topic><topic>Osteoporosis, Postmenopausal - drug therapy</topic><topic>Osteoporosis, Postmenopausal - prevention & control</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Osteoporotic Fractures - prevention & control</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Postmenopause</topic><topic>Prevention</topic><topic>Public Health</topic><topic>Quality of care</topic><topic>Quality of Life Research</topic><topic>Quality-Adjusted Life Years</topic><topic>Reimbursement</topic><topic>Secondary Prevention</topic><topic>Sensitivity analysis</topic><topic>Simulation</topic><topic>Simulation analysis</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiang, Yawen</creatorcontrib><creatorcontrib>Jiang, Shan</creatorcontrib><creatorcontrib>Li, Limin</creatorcontrib><creatorcontrib>Shi, Si</creatorcontrib><creatorcontrib>Li, Mincai</creatorcontrib><creatorcontrib>Si, Lei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>PAIS Index</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>ProQuest One Community College</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Politics Collection</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Politics Collection</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Global</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Political Science Database</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Applied health economics and health policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiang, Yawen</au><au>Jiang, Shan</au><au>Li, Limin</au><au>Shi, Si</au><au>Li, Mincai</au><au>Si, Lei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis</atitle><jtitle>Applied health economics and health policy</jtitle><stitle>Appl Health Econ Health Policy</stitle><addtitle>Appl Health Econ Health Policy</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>21</volume><issue>3</issue><spage>489</spage><epage>499</epage><pages>489-499</pages><issn>1175-5652</issn><issn>1179-1896</issn><eissn>1179-1896</eissn><abstract>Objective
This study evaluated the cost effectiveness of denosumab versus alendronate for secondary prevention of osteoporotic fractures among post-menopausal women in China.
Methods
A validated individual-level simulation model of osteoporotic fractures in the Chinese setting was adapted. Allowing both treatment discontinuation and waning effects, the analysis aimed to evaluate the incremental cost-effectiveness ratio of denosumab compared to alendronate by simulating a cohort of previously fractured individuals over the residual lifetime from the healthcare system perspective. Hip, vertebral, and wrist/humeral fractures were tracked along with the associated medical costs and quality-adjusted life-years. Age-related health state utility values, health state utility values of fractures, costs, fracture incidence, and mortality risks for Chinese were used whenever available. Comparative effectiveness data were obtained from a published network meta-analysis. One-way and probabilistic sensitivity analyses were conducted.
Results
In the base case, denosumab was dominated by alendronate with incremental costs of CN¥2743 (US$425) and incremental health outcomes of − 0.20 quality-adjusted life-years at its current price in mainland China. It remained dominated in all one-way sensitivity analysis robustness checks. However, denosumab was cost effective if both drugs did not carry any waning effects. In the probabilistic sensitivity analysis, denosumab remained dominated in all replications.
Conclusions
Denosumab is not cost effective for preventing secondary fractures among overall postmenopausal women in China. It is advisable to identify alternative denosumab regimens for high-risk subgroups among previously fractured postmenopausal women.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>36626041</pmid><doi>10.1007/s40258-022-00784-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3044-170X</orcidid><orcidid>https://orcid.org/0000-0002-0498-0662</orcidid></addata></record> |
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| subjects | Age groups Alendronate - therapeutic use Antibodies, Monoclonal, Humanized Bisphosphonates Bone Density Conservation Agents - therapeutic use Breast cancer Cancer therapies Cost analysis Cost-Benefit Analysis Cost-Effectiveness Analysis Denosumab - therapeutic use Effectiveness Female Fractures Health Administration Health care expenditures Health Economics Health risks Hip joint Humans Medicine Medicine & Public Health Meta-Analysis as Topic Monoclonal antibodies Mortality Mortality risk Network Meta-Analysis Oral administration Original Research Article Osteoporosis Osteoporosis, Postmenopausal - complications Osteoporosis, Postmenopausal - drug therapy Osteoporosis, Postmenopausal - prevention & control Osteoporotic Fractures - epidemiology Osteoporotic Fractures - prevention & control Pharmacoeconomics and Health Outcomes Postmenopause Prevention Public Health Quality of care Quality of Life Research Quality-Adjusted Life Years Reimbursement Secondary Prevention Sensitivity analysis Simulation Simulation analysis Women Womens health |
| title | Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis |
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