OBJECTIVES : Teriparatide was listed in Critical Disease Medical Assistance System in Qingdao since October 2016. The reimbursement rate of Teriparatide was 80% with a reimbursement restriction of 350 patients in 2018 in Qingdao. This study was to determine the impact of loosening the reimbursement restriction of Teriparatide in treating postmenopausal women with osteoporosis at high risk of fracture in Qingdao, China.

METHODS : A budget impact model was developed with a time horizon of 5 years to simulate the expense of anti-osteoporosis treatment for postmenopausal women from the payer’s perspective. Target population was forecasted using data from Statistical Yearbook, healthcare database and literature review. Market share of Teriparatide and other comparators were collected from the IQVIA database and a growth of 30% patients per year was presumed for Teriparatide after loosening the reimbursement limitation. Direct medical costs and the expenses reduced due to fractures prevented were considered and estimated. Bidding prices of Teriparatide and reference comparators were taken from Qingdao Municipal Bureau of Human Resource and Social Security Website and published data. Budget impact was considered separately for Urban Employee Basic Medical Insurance (UEBMI) and Urban and Rural Resident Basic Medical Insurance (URRBMI). One-way sensitivity analysis was adopted in the model.

RESULTS : The target population over the 5-year timeframe was projected to increase from 561 to 1039. Compared to the current scenario, the annual impact ranged from ¥2,545,277 to ¥20,918,376 from the payer’s perspective, corresponding to 44.39% for urban employees and 55.61% for urban and rural residents in the fifth year, respectively. Sensitivity analysis confirmed the robustness of the results.

CONCLUSIONS : Loosening reimbursement restriction on Teriparatide in treating postmenopausal women with osteoporosis at high risk of fracture will lead to acceptable budgetary impact, promote drug accessibility and decrease the economic burden of patients.