Treatment of established osteoporosis: a systematic review and cost-utility analysis

Abstract

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Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan

“…To date, the efficacy and cost-effectiveness of osteoporosis treatments, such as alendronate, have been studied extensively. (8)(9)(10)(11) However, it is less clear whether postmenopausal women with osteopenia should be treated with pharmaceuticals. One study from Europe showed that the cost-effectiveness of alendronate in osteopenic women without a history of fracture varies depending on the setting of each country, discount rate, and willingness to pay thresholds.…”

Health economics of osteoporosis

“…In line with a recent meta-analysis of the effects of bisphosphonates in post-menopausal osteoporosis [144] a relative risk reduction of treatment of 35% was assumed. A five-year intervention was assumed, which was chosen to approximate the time period for which there is direct or indirect clinical data on intervention effects.…”

“…However, durations of three and ten years were also tested in sensitivity analyses. After stopping treatment, the risk reduction was assumed to reverse in a linear manner (also called the offset time of treatment effect) over a five-year period [118,144,145] in the base case.…”

“…Another indirect comparison which might seem relevant could be to compare with bisphosphonates which are the most prescribed drug class and the suggested first line treatment for osteoporosis. Using the estimated fracture risk reduction for alendronate based on a meta-analysis [144] showed alendronate to be the most cost-effective treatment at all starting ages between 60-80 years, which is mainly due to a lower drug price and better point estimates on fracture risk reduction. What can be noticed is that current Swedish treatment guidelines and reimbursement decisions are in line with these results, i.e.…”

Potential role of FRAX analysis in postmenopausal women with osteopenia

“…Taking into account that the incidence of osteoporosis is 30-40% [5], the number of persons with osteoporosis in Serbia is 505 000 to 674.000. Having in mind that the risk of osteoporotic fractures is 10% [6], it could be estimated that 3500 to 5500 fractures may occur in Serbia annually.…”