Objective:

To evaluate denosumab economically compared with a mixed scenario of zoledronic acid or no treatment if there is contraindication to such agent due to severe kidney impairment (Mix ZA/No Trt) in patients with solid tumors (ST) with bone metastasis.

Method:

It is a cost-effectiveness analysis based on a Markov model with a lifetime horizon, under the IMSS perspective. We evaluated the frequencies of skeletal-related events (SREs) as well as the costs associated to drug acquisition, intravenous infusion of ZA, routine patient management, medical attention of SREs, and treatment of serious adverse events.

Results:

In the base-case, denosumab resulted dominant over Mix ZA/No Trt, with mean savings of $2,494 Mexican pesos and 0.781 SREs avoided per patient. If ZA is given every 12 weeks, denosumab would not be dominant, but cost-effective. Denosumab was either dominant or cost-effective in 74.7% of the simulations.

Conclusions:

In patients with ST with bone metastasis, denosumab represents a dominant or at least a cost-effective intervention in comparison with Mix ZA/No Trt.

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