Switching to denosumab saves money by preventing skeletal-related events


Mickael Lothgren (International Health Economics and Reimbursement, Amgen, Switzerland) and others reported in the European Journal of Hospital Pharmacy that switching patients with solid tumours and bone metastases from zoledronic acid (Zometa, Novartis) to denosumab (Xgeva, Amgen) represents good value for money because it is associated with a reduction in risk of skeletal-related events.  

Lothgren et al wrote that compared with zoledronic acid, in patients with solid tumours, denosumab reduces the risk of first skeletal-related events and also delays the time to multiple skeletal-related events. They noted that the objective of their study was to “assess the cost complications per patient per year, and to predict the potential annual budget impact, when patients with bone metastases secondary to solid tumours at risk of skeletal-related events transitioned from treatment with zoledronic acid to treatment with denosumab.”  The authors added that they performed analyses in Austria, Sweden, and Switzerland.

Using real-world data, Lothgren et al found that the switch from zoledronic acid to denosumab was associated with cost savings in each of the countries examined. They reported: “The estimated total annual cost savings per patient transitioned from treatment with zoledronic acid to denosumab varied by country and tumour type and ranged from €1,583 to €2,375 in Austria, from €1,980 to €2,319 in Sweden and from €3,408 to €3,857 in Switzerland.” The cost savings, according to the authors, were “mainly driven” by the delay in time to the first and multiple skeletal-related events, the lower costs of skeletal-related events, and the lower administration costs associated with denosumab compared with zoledronic acid. They added: “Based on these findings, the predicted total annual cost savings for every 1,000 patients transitioned from zoledronic acid to denosumab ranged from €1.6 million to €2.4 million in Austria, from €2 million to €2.3 million in Sweden, and from €3.4 million to €3.6 million in Switzerland.” Additionally, Lothgren et al noted that they still observed cost savings with denosumab when the price of zoledronic acid was reduced by up to 38–54% in Austria, 46–52% in Sweden, and 71–79% in Switzerland.  

The authors concluded that denosumab “represents good value for money in preventing skeletal-related events in patients with bone metastases from solid tumours in Austria, Sweden, and Switzerland.”