Table 5.

Results of Scenario Analysis for Base Case Population^a

Scenario	Sequential Result
Base case	ICER for A v. NT = $3,751
	ICER for Z v. A = $666,285
	ICER for D v. Z = $13.0 million
	E and R subject to dominance
Set time = 0 years	ICER for A v. NT = $7,972
	ICER for Z v. A = $838,746
	E, R, and D subject to dominance
Set time = 5 years	ICER for Z v. A = $643,327
	NT, E, R, and D subject to dominance
Discount rate = 0%	I ICER for A v. NT = $2,577
	ICER for Z v. A = $608,211
	ICER for D v. Z = $8.3 million
	E and R subject to dominance
Discount rate = 3%	ICER for A v. NT = $5,548
	ICER for Z v. A = $800,853
	ICER for D v. Z = $47.1 million
	E and R subject to dominance
Discount rate = 5%	ICER for A v. NT = $6,435
	ICER for Z v. A = $839,796
	E, R, and D subject to dominance
Inclusion of non-osteoporotic health care costs	ICER for A v. NT = $3,749
	ICER for Z v. A = $770,725
	ICER for D v. Z = $4.8 million
	E and R subject to dominance
Scenario analysis favoring denosumabb	ICER for D v. A = $165,490
	NT and R dominated by A

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.

^bAnalysis compares only no therapy, alendronate, risedronate, and denosumab. Analysis based on assumptions favorable to denosumab relating to calibration, vertebral facture costs, and mortality and treatment effectiveness adopted in previous manufacturer sponsored studies.