Table 2.
Results of scenario analysis on treatment persistence
| 10-year fracture probability (%) | RR of hip fracture | RR of major fracture | QALYs | Incremental QALYs |
Cost (USD) | Incremental cost (USD) |
ICER (USD per QALY) | INMB (USD) |
||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hip fracture | Vertebral fracture | Other fracture | ||||||||||
| 70 years old, T-score −2.0 | ||||||||||||
| BT | 2.20 | 9.20 | 6.20 | – | – | 11.331 | – | 17,530 | – | – | – | |
| ALN + BT (vs BT) | 2.00 | 8.30 | 5.90 | 0.909 | 0.920 | 11.346 | 0.015 | 17,830 | 300 | 19,904 | 453 | |
| ZOL + BT (vs ALN + BT) | 1.90 | 7.30 | 5.50 | 0.950 | 0.907 | 11.356 | 0.010 | 18,326 | 497 | 47,435 | 27 | |
| 65 years old, T-score −2.5 | ||||||||||||
| BT | 2.50 | 9.50 | 7.00 | – | – | 13.472 | – | 23,988 | – | – | – | |
| ALN + BT (vs BT) | 2.30 | 8.60 | 6.60 | 0.920 | 0.921 | 13.503 | 0.031 | 24,029 | 41 | 1322 | 1499 | |
| ZOL + BT (vs ALN + BT) | 2.20 | 7.60 | 6.20 | 0.957 | 0.914 | 13.520 | 0.017 | 24,447 | 418 | 25,067 | 416 | |
| 70 years old, T-score −2.5 | ||||||||||||
| BT | 3.60 | 12.00 | 7.30 | – | – | 11.167 | – | 20,364 | – | – | – | |
| ALN + BT (vs BT) | 3.30 | 10.80 | 6.90 | 0.917 | 0.917 | 11.193 | 0.026 | 20,460 | 95 | 3620 | 1222 | |
| ZOL + BT (vs ALN + BT) | 3.10 | 9.50 | 6.40 | 0.939 | 0.905 | 11.209 | 0.015 | 20,868 | 408 | 27,018 | 347 | |
| 75 years old, T-score −2.5 | ||||||||||||
| BT | 5.20 | 14.80 | 7.30 | – | – | 8.905 | – | 16,755 | – | – | – | |
| ALN + BT (vs BT) | 4.60 | 13.30 | 6.80 | 0.885 | 0.905 | 8.934 | 0.029 | 16,885 | 130 | 4523 | 1309 | |
| ZOL + BT (vs ALN + BT) | 4.40 | 11.60 | 6.30 | 0.957 | 0.903 | 8.948 | 0.014 | 17,252 | 367 | 25,747 | 346 | |
| 70 years old, T-score −3.0 | ||||||||||||
| ALN + BT | 5.30 | 14.10 | 8.10 | – | – | 10.979 | – | 24,209 | – | – | – | |
| ZOL + BT (vs ALN + BT) | 5.00 | 12.40 | 7.50 | 0.943 | 0.905 | 11.000 | 0.022 | 24,443 | 235 | 10,749 | 857 | |
| BT (vs ZOL + BT) | 66.00 | 15.70 | 8.60 | 1.200 | 1.217 | 10.935 | −0.065 | 24,534 | 91 | Dominated | −3341 | |
BT: basic treatment (placebo + calcium + vitamin D), ZOL: once-yearly injection of zoledronic acid 5 mg, ALN: once-weekly oral alendronate 35 mg. 1 USD = 120 JPY (February 2016 exchange rate). All strategies were ranked according to costs
RR relative risk, QALYs quality-adjusted life years, ICER incremental cost-effectiveness ratio, INMB incremental net monetary benefit