Evaluación económica de denosumab en la prevención de eventos relacionados con el esqueleto en pacientes con mieloma múltiple en México

Abstract

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.