Effectiveness and cost-effectiveness of osteoporosis drugs

Generics/Research | Posted 16/10/2015 post-comment0 Post your comment

Comparison of treatments for osteoporosis has shown that pharmacological intervention for prevention of secondary fractures is cost-effective [1].

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Osteoporosis-related fractures in the elderly are a significant burden on the healthcare system, with an estimated 30% of the cost following a hip fracture coming from the need for long-term nursing home care. With the ageing of the population, the burden of osteoporosis-related fractures is likely to increase.

Colleagues from the Norwegian University of Science and Technology, Oslo University Hospital and University of Oslo evaluated the relative health gains and costs of secondary prevention of fractures with generic alendronate, risedronate, denosumab and zoledronic acid, compared to no treatment and relative to each other.

Their results were presented at the 37th Annual Meeting of the Society for Medical Decision Making, which will take place in St Louis, MO, USA on 18–21 October 2015.

They found that zoledronic acid was the most effective alternative, followed by denosumab, risedronate, generic alendronate and no treatment, yielding respectively 4.7661, 4.7640, 4.6715, 4.1581 and 3.8915 quality-adjusted life years (QALYs). Generic alendronate had lower costs than no secondary prevention. Zoledronic acid was more effective and less costly than both denosumab and risedronate. Compared to alendronate, zoledronic acid entails costs of US$48,832 per additional QALY.

The authors concluded that ‘all options are more effective than no treatment’. They added that ‘in terms of comparative effectiveness and cost[-]effectiveness’ their analysis indicated that ‘zoledronic acid is the optimal strategy for secondary prevention, assuming a cost-effectiveness threshold of US$50,000 per QALY gained’.

Conflict of interest
The authors of the abstract [1] did not provide any conflict of interest statement.

Editor’s comment
It should be noted that this abstract was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

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Reference
1.  Hagen G, Sønbø Kristiansen I, Wisløff T. Comparative effectiveness and cost effectiveness of generic alendronate, risedronate, denosumab and zoledronic acid for secondary prevention of fragility fractures- preliminary results. Poster PS3-5. 37th Annual Meeting of the Society for Medical Decision Making; 18-21 October 2015; St Louis, MO, USA.

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