Cost-effectiveness of alendronate in the treatment of low bone mineral density in the time of price competition
Year: 2007
Type: dissertation
Abstract: Background: Norwegian guidelines recommend treatment with bisphosphonates for women\nconsidered at high risk of osteoporosis. Alendronate is the most used bisphosphonate.\nRecently the price of alendronate has fallen by 75% due to the expiring of the patent. This\nmay influence the cost effectiveness of the drug.\nObjective: To estimate the incremental costs and effects of treating postmenopausal,\nosteopenic women with alendronate in addition to calcium and vitamin D instead of calcium\nand vitamin D alone.\nDesign: Markov model with seven health states: well, well after fracture, mild hip fracture\nsequela, moderate hip fracture sequela, severe hip fracture sequela, vertebral sequela and\ndead. The model encompasses three events: hip, vertebral and forearm fracture.\nData sources: Literature searches in the databases Medline, EMBASE and Cochrane to\nidentify data on fracture incidence, efficacy, of alendronate and quality of life. Costs are\nestimated using Norwegian fee schedules for 2006. Mortality rates for 2006 from Statistics\nNorway.\nTarget population: Postmenopausal women, aged 65-75 with femoral neck T-score between\n-1.5 and -2.5 living in Oslo.\nTime horizon: Until death or age of 100.\nPerspective: Broad health care\nInterventions: Four years of treatment with alendronate. Offset time three years.\nOutcome measures: The results are expressed as incremental costs, incremental quality\nadjusted life years, and costs per QALY gained.\nResults: Treatment with alendronate was cost saving and more effective for all groups.\nResults of sensitivity analysis: The results of the one-way sensitivity analyses indicate that\nthis conclusion is robust to any realistic change of the model input.\nLimitations: Results apply mainly to postmenopausal, Caucasian women in Oslo.\nConclusions: The results indicate that treatment with alendronate, at the current price level, is\ncost saving and more effective compared to no treatment for a wide group of women
Authors: Gunhild Hagen, Janicke Nevjar
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2402031114