Gaceta Mexicana de Oncología (Apr 2022)

Economic evaluation of denosumab in the prevention of skeletal-related events in patients with multiple myeloma in Mexico

  • Fernando Carlos-Rivera,
  • Jorge A. Guzmán-Caniupan,
  • Adolfo Hernández-Garduño,
  • Mónica Alva-Esqueda,
  • Therese Aubry-de Maraumont,
  • Luis M. Camacho-Cordero

DOI
https://doi.org/10.24875/j.gamo.M22000227
Journal volume & issue
Vol. 21, no. 2

Abstract

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Objectives: To undertake an economic evaluation of denosumab in comparison with a mixed scenario consisted of zoledronic acid or no treatment if there is a contraindication to this agent due to severe renal impairment (Mix ZA/No tx) in patients with multiple myeloma (MM). Methods: The analysis adopted the perspective of the Mexican public health care system as a payer. This is a partitioned-survival five-stages semi-Markov model for a life-time horizon. We evaluated the frequencies of skeletal-related events (SREs) as well as the costs associated to drug acquisition/infusion, routine patient management, medical attention of SREs, treatment of serious adverse events, and anti-myeloma treatment. Results: Denosumab use was more expensive but also more effective, with incremental cost-effectiveness ratios of $13,942 Mexican pesos (MXN) per SRE avoided and $1,893 MXN per additional month of progression-free survival. In general, the model is robust. Conclusions: In patients with MM, denosumab represents a cost-effective intervention in comparison with the Mix ZA/No tx.

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