Table 4.

Sequential Cost Utility Analysis Results for Alternative Patient Populations^a

Age	No Previous Fracture	Previous Fracture
Patients able to tolerate oral bisphosphonates
65–69	ICER for Z v. A = $1.4 million	ICER for Z v. A = $3.1 million
	ICER for D v. Z = $7.3 million	NT, E, R, and D subject to dominance
	NT, E, and R subject to dominance
70–74	ICER for A v. NT = $3,751	ICER for Z v. A = $1.6 million
	ICER for Z v. A = $666,285	NT, E, R, and D subject to dominance
	ICER for D v. Z = $13.0 million
	E and R subject to dominance
75–79	ICER for Z v. A = $816,389	ICER for Z v. A = $5.2 million
	NT, E, R, and D subject to dominance	NT, E, R, and D subject to dominance
80–84	ICER for Z v. A = $1.1 million	A optimal as Z, NT, E, R, and D subject to dominance
	NT, E, R, and D subject to dominance
85–89	A optimal as Z, NT, E, R, and D subject to dominance	A optimal as Z, NT, E, R, and D subject to dominance
90+	ICER for A v. NT = $2,721	A optimal as Z, NT, E, R, and D subject to dominance
	ICER for Z v. A = $1.3 million
	E, R, and D subject to dominance
Patients unable to tolerate oral bisphosphonates b
65–69	ICER for Z v. NT = $94,365	ICER for Z v. NT = $41,374
	ICER for D v. Z = $7.3 million	D subject to dominance
70–74	ICER for Z v. NT = $83,503	ICER for Z v. NT = $40,956
	ICER for D v. Z = $3.0 million	D subject to dominance
75–79	ICER for Z v. NT = $63,263	ICER for Z v. NT = $20,408
	D subject to dominance	D subject to dominance
80–84	ICER for Z v. NT = $48,142	ICER for Z v. NT = $13,484
	D subject to dominance	D subject to dominance
85–89	ICER for Z v. NT = $51,296	ICER for Z v. NT = $17,770
	D subject to dominance	D subject to dominance
90+	ICER for Z v. NT = $46,842	ICER for Z v. NT= $17,796
	D subject to dominance	D subject to dominance

A, alendronate; D, denosumab; E, etidronate; ICER, incremental cost per QALY gained; NT, no therapy; QALY, quality-adjusted life year; R, risedronate; Z, zoledronate.

^aCosts represent CAN$ in 2017.

^bComparison of no therapy, denosumab and zoledronate.