OBJECTIVE  To analyze the cost and utility of denosumab and zoledronic acid in preventing skeletal-related events in patients with multiple myeloma, in order to provide a basis for optimizing clinical medication strategies.

METHODS From the payer's perspective, data from the phase III clinical trial NCT01345019 was used, and related cost data were obtained from domestic literature. A dynamic Markov model was employed to evaluate the cost and utility of denosumab and zoledronic acid regimens, followed by one-way sensitivity analysis and probabilistic sensitivity analysis of the cost-utility results.

RESULTS  The denosumab group spent 21 638.181 9 yuan to gain 14.7004 QALYs, while the zoledronic acid group spent 9 573.065 8 yuan to gain 14.6315 QALYs, resulting in an incremental cost-utility ratio of 175 263.742 4 yuan/QALY. When the willingness-to-pay threshold was set at three times the average per capita GDP in China, 268 074 yuan/QALY, the denosumab group had a probability of cost-utility of 93.4%. The drug cost of denosumab was the most sensitive model parameter affecting the results.

CONCLUSION  For patients in China preventing skeletal-related events of multiple myeloma, denosumab has a more cost-effective advantage compared to zoledronic acid.