Systematic review of the clinical and cost-effectiveness, and economic evaluation of denosumab for the treatment of bone metastases from solid tumours


This NIHR HTA-funded project assessed the clinical and cost effectiveness of denosumab for the prevention of skeletal related events (SREs) in patients with bone metastases from solid tumours. A systematic review was conducted for clinical and cost effectiveness studies assessing denosumab, bisphosphonates (e.g. zoledronic acid) or best supportive care (BSC) in patients with bone metastases. Compared to zoledronic acid and placebo, denosumab was effective in delaying SREs. Cost utility modelling results for denosumab relative to zoledronic acid were driven by the availability of the patient access scheme (PAS) for denosumab.  Without the PAS, denosumab was not estimated to be cost effective relative to either zoledronic acid or BSC. With the PAS, denosumab was estimated to be cost effective relative to zoledronic acid but not BSC.

For further details of this project see:


Pawana Sharma;




Ford, JA., Cummins, E., Sharma, P., Elders, A., Stewart, F., Johnston, R., Royle, P., Jones, R., Mulatero, C., Todd, R. & Mowatt, G. (2013). 'Systematic review of the clinical effectiveness and cost-effectiveness, and economic evaluation, of denosumab for the treatment of bone metastases from solid tumours'. Health technology assessment (Winchester, England), vol 17, no. 29, pp. 1-386.

Ford, JA., Jones, R., Elders, A., Mulatero, C., Royle, P., Sharma, P., Stewart, F., Todd, R. & Mowatt, G. (2013). 'Denosumab for treatment of bone metastases secondary to solid tumours: systematic review and network meta-analysis'. European Journal of Cancer, vol 49, no. 2, pp. 416-430.