Objectives:

To undertake an economic evaluation of denosumab in comparison with a mixed scenario consisted of zoledronic acid or no treatment if there is a contraindication to this agent due to severe renal impairment (Mix ZA/No trt) in patients with multiple myeloma (MM).

Methods:

The analysis adopted the perspective of the Mexican public health care system as a payer. This is a partitioned-survival five-stages semi-Markov model for a life-time horizon. We evaluated the frequencies of skeletal-related events (SREs) as well as the costs associated to drug acquisition/infusion, routine patient management, medical attention of SREs, treatment of serious adverse events, and anti-myeloma treatment.

Results:

Denosumab use was more expensive but also more effective, with incremental cost-effectiveness ratios of $13,942 Mexican pesos (MXN) per SRE avoided and $1,893 MXN per additional month of progression-free survival. In general, the model is robust.

Conclusions:

In patients with MM, denosumab represents a cost-effective intervention in comparison with the Mix ZA/No trt.

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