Trends in hip fracture incidence and in the prescription of antiosteoporosis medications during the same time period in Belgium (2000–2007)

Hiligsmann, Mickaël; Bruyère, Olivier; Roberfroid, Dominique; Dubois, Cécile; Parmentier, Yves; Carton, Joëlle; Detilleux, Johann; Gillet, Pierre; Reginster, Jean‐Yves

doi:10.1002/acr.21607

Cited by 40 publications

(29 citation statements)

References 40 publications

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“…We used the total number of anti-osteoporotic medication for the entire population to explain the trend of hip fractures in women, based on our preliminary results that showed no increasing or decreasing trends in ASIR for men. The stable incidence rates of hip fractures among men is compatible with the low prescription of anti-osteoporotic medication for men identified in other countries [12] and information contained in Portuguese national guidelines [18] and [19] which focus the prevention of osteoporosis in women. The medications analyzed were those indicated as agents that can act on the inhibition of bone loss or promote directly bone formation [20] and [21] with a high evidence level of reducing the risk of a hip fracture: bisphosphonates, calcitonin, hormonal replacement therapy (HRT), Strontium ranelate and Selective Estrogen Receptor Modulators (Reloxifene) as well as vitamin D (recommended to be prescribed in association with the medications mentioned [19]).…”

Section: Study Areasupporting

confidence: 65%

“…However in Finland the decrease pattern was observed in both genders, whereas in Australia only women presented a decreasing pattern. Rates presenting linear decreases have been reported by studies in Belgium [12], Denmark [13], Canada [14], United States [15] for both genders and Spain just for women [16]. Unique causes are impossible to assess, nevertheless studies have pointed out different plausible reasons, according to their results, namely medication for osteoporosis [10], [11] and [16] or other interventions [13] and [14].…”

Section: Introductionmentioning

confidence: 98%

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Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Alves¹,

Economou

Oliveira

et al. 2013

Bone

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The aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication.From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.

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Section: Study Areasupporting

confidence: 65%

Section: Introductionmentioning

confidence: 98%

Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Alves¹,

Economou

Oliveira

et al. 2013

Bone

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“…The risk of hip fracture was derived from the Belgian national database of hospital bills [14]. Since the incidence of non-hip fracture was not known, we applied the age-specific ratio of index fracture to hip fracture in Belgium as found in Sweden [15].…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of personalized supplementation with vitamin D-rich dairy products in the prevention of osteoporotic fractures

et al. 2015

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SummaryTitrated supplementations with vitamin D-fortified yogurt, based on spontaneous calcium and vitamin D intakes, can be cost-effective in postmenopausal women with or without increased risk of osteoporotic fractures.IntroductionThe objective of this study is to assess the cost-effectiveness of the vitamin D-fortified yogurt given to women with and without an increased risk of osteoporotic fracture.MethodsA validated cost-effectiveness microsimulation Markov model of osteoporosis management was used. Three personalized supplementation scenarios to reflect the Ca/Vit D needs taking into account the well-known variations in dietary habits and a possible pharmacological supplementation in Ca/Vit D, given above or in combination with anti-osteoporosis medications: one yogurt per day, i.e., 400 mg of Ca + 200 IU of Vit D (scenario 1 U), two yogurts per day, i.e., 800 mg of Ca + 400 IU of Vit D (scenario 2 U), or three yogurts per day, i.e., 1,200 mg of Ca + 600 IU of Vit D (scenario 3 U).ResultsOne yogurt is cost-effective in the general population above the age of 70 years and in all age groups in women with low bone mineral density (BMD) or prevalent vertebral fracture (PVF). The daily intake of two yogurts is cost-effective above 80 years in the general population and above 70 years in the two groups of women at increased risk of fractures. However, an intake of three yogurts per day is only cost-effective above 80 years old in the general population, as well as in women with low BMD or PVF.ConclusionsOur study is the first economic analysis supporting the cost-effectiveness of dairy products, fortified with vitamin D, in the armamentarium against osteoporotic fractures.

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“…The base‐case population was women aged 70 years with a BMD T ‐score below the threshold value for osteoporosis (ie, BMD T ‐score ≤ −2.5) and without any fracture. The incidence of first hip fracture in the general women population was derived from the national database of hospital bills (average of the years 2005–2007) 20. Because the incidence of other fractures was not known, we assumed that the age‐specific ratio of index fracture to hip fracture in Belgium was the same as found in Sweden 21.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of bazedoxifene compared with raloxifene in the treatment of postmenopausal osteoporotic women

Hiligsmann

Sedrine

Reginster

2012

Journal of Bone and Mineral Research

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Bazedoxifene is a novel selective estrogen receptor modulator (SERM) for the prevention and treatment of osteoporosis. In addition to the therapeutic value of a new agent, evaluation of the cost-effectiveness compared with relevant alternative treatment(s) is an important consideration to facilitate healthcare decision making. This study evaluated the cost-effectiveness of bazedoxifene compared with raloxifene for the treatment of postmenopausal women with osteoporosis. The cost-effectiveness of treatment for 3 years with bazedoxifene was compared with raloxifene using an updated version of a previously validated Markov microsimulation model. Analyses were conducted from a Belgian healthcare payer perspective and, the base-case population was women (aged 70 years) with bone mineral density T-score À2.5. The effects of bazedoxifene and raloxifene on fracture risk were derived from the 3-year results of a randomized, double-blind, placebo-controlled and active-controlled study, including postmenopausal women with osteoporosis. The cost-effectiveness analysis based on efficacy data from the overall clinical trial indicated that bazedoxifene and raloxifene were equally cost-effective. When the results were examined based on the subgroup analysis of women at higher risk of fractures, bazedoxifene was dominant (lower cost for higher effectiveness) compared with raloxifene in most of the simulations. Sensitivity analyses confirmed the robustness of the results, which were largely independent of starting age of treatment, fracture risk, cost, and disutility. In addition, when the cost of raloxifene was reduced by one-half or when incorporating the raloxifene effects on reducing breast cancer, bazedoxifene remained cost-effective, at a threshold of s35,000 per quality-adjusted life-years gained, in 85% and 68% of the simulations, respectively. Under the assumption of improved antifracture efficacy of bazedoxifene over raloxifene in women with high risk of fractures, this study suggests that bazedoxifene can be considered cost-effective, and even dominant, when compared with raloxifene in the treatment of postmenopausal osteoporotic women. ß

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Trends in hip fracture incidence and in the prescription of antiosteoporosis medications during the same time period in Belgium (2000–2007)

Cited by 40 publications

References 40 publications

Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Cost-effectiveness of personalized supplementation with vitamin D-rich dairy products in the prevention of osteoporotic fractures

Cost-effectiveness of bazedoxifene compared with raloxifene in the treatment of postmenopausal osteoporotic women

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