Cost-utility of long-term strontium ranelate treatment for postmenopausal osteoporotic women.

[en] The results of this study suggested that long-term treatment with strontium ranelate over 5 years is cost-effective compared to no treatment for postmenopausal osteoporotic women. INTRODUCTION: This study aims to estimate the cost-effectiveness of long-term strontium ranelate treatment for postmenopausal osteoporotic women. METHODS: A validated Markov microsimulation model with a Belgian healthcare cost perspective was used to assess the cost per quality-adjusted life-year (QALY) of strontium ranelate compared to no treatment, on a basis of calcium/vit D supplementation if needed. Analyses were performed for women aged 70, 75, and 80 years either with a bone mineral density T-score </= -2.5 SD or with prevalent vertebral fractures. The relative risk of fracture during therapy was derived from the Treatment of Peripheral Osteoporosis Study trial over 5 years of treatment. Parameter uncertainty was evaluated using both univariate and probabilistic sensitivity analyses. RESULTS: Strontium ranelate was cost-saving at the age of 80 years in both populations. For women with a T-score </= -2.5 SD, the costs per QALY gained of strontium ranelate were respectively <euro>15,096 and <euro>6,913 at 70 and 75 years of age while these values were <euro>23,426 and <euro>9,698 for women with prevalent vertebral fractures. Sensitivity analyses showed that the results were robust over a wide range of assumptions. CONCLUSION: This study suggested that, compared to no treatment, long-term strontium ranelate treatment is cost-effective for postmenopausal osteoporotic women.

Disciplines :

Rheumatology
Special economic topics (health, labor, transportation...)

Author, co-author :

Hiligsmann, Mickaël ; Université de Liège - ULiège > HEC - École de gestion de l'ULiège > Economie industrielle

Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique - Département des sciences de la santé publique

Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique

Language :

English

Title :

Cost-utility of long-term strontium ranelate treatment for postmenopausal osteoporotic women.

Publication date :

2010

Journal title :

Osteoporosis International

ISSN :

0937-941X

eISSN :

1433-2965

Publisher :

Springer Science & Business Media B.V., Godalming, United Kingdom

Volume :

Pages :

157-165

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 06 May 2009

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Bibliography

1. Boonen S, Body JJ, Boutsen Y et al (2005) Evidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club. Osteoporos Int 16:239-254 (Pubitemid 40379423)
Lyles KW, Colon-Emeric CS, Magaziner JS et al (2007) Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture, N Engl J Med 357:1799-1809, nihpa40967
Harris ST, Reginster JY, Harley C et al (2009) Risk of fracture in women treated with monthly oral ibandronate or weekly bisphosphonates: The evaluation of IBandronate Efficacy (VIBE) database fracture study. Bone. doi:10.1016/j.bone.2009.01.002
4. Meunier PJ, Roux C, Seeman E et al (2004) The effects of strontium, ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459-468 (Pubitemid 38133766)
5. Reginster JY, Felsenberg D, Boonen S et al (2008) Effects of long-term strontium ranelate treatment on the risk of nonvertebral and vertebral fractures in postmenopausal osteoporosis: results of a five-year, randomized, placebo-controlled trial. Arthritis Rheum 58:1687-1695 (Pubitemid 351847521)
6. Reginster JY, Seeman E, De Vernejoul MC et al (2005) Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women, with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin. Endocrinol Metab 90:2816-2822 (Pubitemid 40686329)
7. Seeman E, Devogelaer JP, Lorenc R et al (2008) Strontium ranelate reduces the risk, of vertebral fractures in. patients with. osteopenia. J Bone Miner Res 23:433-438 (Pubitemid 351304674)
Hoffmann C, Graf von der Schulenburg JM (2000) The influence of economic evaluation studies on. decision making. A. European survey. The EUROMET group. Health Policy 52:179-192
Drummond M, Dubois D, Garattini L et al (1999) Current trends in the use of pharmacoeconomics and outcomes research in europe. Value Health 2:323-332
Hiligsmann M, Ethgen O, Bruyère O, et al (2009) Development and validation, of a Markov microsimulation model for the economic evaluation of treatments in. osteoporosis. Value Health, doi: 10.1111/ j.1524-4733.2008.00497
Cleemput I, Crott R, Vrijens F et al (2008) Recommandations provisoires pour les évaluations pharmacoéconomiques en Belgique. Health Technology Assessment (HTA). Bruxelles: Centre Fédéral d'Expertise des Soins de Santé (KCE). KCE reports vol. 78B (D/2008/10.273/24)
12. Dere W, Avouac B, Boers M et al (1998) Recommendations for the health economics analysis to be performed with a drug to be registered in prevention or treatment of osteoporosis. Calcif Tissue Int 63:93-97 (Pubitemid 28347679)
13. Reginster JY, Gillet P, Ben Sedrine W et al (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15:507-514 (Pubitemid 29210953)
14. Autier P, Haentjens P, Bentin J et al (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int 11:373-380 (Pubitemid 30450118)
15. Reginster JY, Gillet P, Gosset C (2001) Secular increase in the incidence of hip fractures in Belgium between 1984 and 1996: need for a concerted public health strategy. Bull World Health. Organ 79:942-946 (Pubitemid 33027173)
Gabriel SE, Tosteson AN, Leibson CL et al (2002) Direct medical, costs attributable to osteoporotic fractures. Osteoporos Int 13:323-330
Melton LJ 3rd, Gabriel SE, Crowson CS et al (2003) Costequivalence of different osteoporotic fractures. Osteoporos Int 14:383-388
Hiligsmann M, Ethgen O, Richy F et al (2008) Utility values associated with osteoporotic fracture: a systematic review of the literature. Calcif Tissue Int 82:288-292
Hiligsmann M, Bruyère O, Ethgen O et al (2008) Lifetime absolute risk of hip and other osteoporotic fracture in Belgian women. Bone 43:991-994
20. Kanis JA, Johnell O, Oden A et al (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585-590 (Pubitemid 30808794)
21. Looker AC, Wanner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468-489 (Pubitemid 28486716)
22. Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254-1259 (Pubitemid 26147662)
23. Johnell O, Kanis JA, Oden A et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185-1194 (Pubitemid 40863806)
Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721-739
25. Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375-382 (Pubitemid 38953182)
26. Caulin F, Kanis JA, Johnell O et al (2002) Optimal age for preventing osteoporosis after menopause depends on effects of stopping treatment. Bone 30:754-758 (Pubitemid 34467998)
27. Jonsson B, Kanis J, Dawson A et al (1999) Effect and offset of effect of treatments for hip fracture on health outcomes. Osteoporos Int 10:193-199 (Pubitemid 29458713)
Meunier PJ, Roux C, Ortolani S et al (2008) Effects of long-term strontium ranelate treatment on vertebral, fracture risk in postmenopausal women with osteoporosis, doi: 10.1007/s00198-008-0825-6
29. Zethraeus N, Borgstrom. F, Strom O et al (2007) Costeffectiveness of the treatment and prevention of osteoporosis-a review of the literature and a reference model. Osteoporos Int 18:9-23 (Pubitemid 44885492)
30. Borgstrom F, Jonsson B, Strom O et al (2006) An economic evaluation of strontium ranelate in. the treatment of osteoporosis in a Swedish setting: based on the results of the SOTI and TROPOS trials. Osteoporos Int 17:1781-1793 (Pubitemid 44607399)
31. Lekkerkerker F, Kanis JA, Alsayed N et al (2007) Adherence to treatment of osteoporosis: a need for study. Osteoporos Int 18:1311-1317 (Pubitemid 47389473)
Rabenda V, Mertens R, Fabri V et al (2008) Adherence to bisphosphonates therapy and hip fracture risk in osteoporotic women. Osteoporos Int 19:811-818
33. Cramer JA, Roy A, Burrell A et al (2008) Medication compliance and persistence: terminology and definitions. Value Health 11:44-47 (Pubitemid 351160875)
Belgian Center for Pharmacotherapeutic Information, 2008, Available from:http://www.cbip.be/GGR/MPG/MPG-NJ.cfm#MP-2583
Kanis J, Burlet N, Cooper C et al (2008) European guidance for the diagnosis and. management of osteoporosis in postmenopausal women. Osteoporos Int 19:399-1128
Briggs A, Sculpher M, Claxton. K (2006) Modelling methods for health economic evaluation. Oxford University Press, New York
Neuprez A, Hiligsmann M, Scholtissen S et al (2008) Strontium ranelate: the first agent of a new therapeutic class in osteoporosis. Adv Ther 25:1235-1256
Cleemput I, Neyt M, Thiry N et al (2008) Valeurs seuils pour le rapport coût-efficacité en soins de santé. Health Technology Assessment (HTA). Bruxelles: Centre fédéral d'expertise des soins de santé (KCE);2008. KCE Reports 100.B (D/2008/10,273/95)
Raftery J (2001) NICE: faster access to moder treatments? Analysis of guidance on health technologies. Br Med J 323:1300-1303
40. Strom O, Borgstrom F, Sen SS et al (2007) Cost-effectiveness of alendronate in the treatment of postmenopausal, women in 9 European countries-an economic evaluation based on the fracture intervention trial. Osteoporos Int 18:1047-1061 (Pubitemid 47020004)
41. Borgstrom F, Johnell O, Kanis JA et al (2004) Cost effectiveness of raloxifene in. the treatment of osteoporosis in Sweden: an economic evaluation based on the MORE study. Pharmacoeconomics 22:1153-1165 (Pubitemid 39665345)
Kanis JA, Adams J, Borgstrom. F et al (2008) The costeffectiveness of alendronate in the management of osteoporosis. Bone 42:4-15
Stevenson. M, Lloyd Jones M, De Nigris E et al (2005) A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess 9:1-160
Borgstrom F, Kanis JA (2008) Health economics of osteoporosis. Best Pract Res Clin Endocrinol Metab 22:885-900
45. Al MJ, Feenstra T, Brouwer WB (2004) Decision makers' views on health care objectives and budget constraints: results from, a pilot study. Health Policy 70:33-48 (Pubitemid 39092958)
46. Mauskopf JA, Sullivan SD, Annemans L et al (2007) Principles of good practice for budget impact analysis: report of the ISPOR Task Force on good research practices-budget impact analysis. Value Health 10:336-347 (Pubitemid 47481105)
47. Bruyere O, Delferriere D, Roux. C et al. (2008) Effects of strontium ranelate on. spinal osteoarthritis progression. Ann Rheum Dis 67:335-339 (Pubitemid 351281267)
Marquis P, Roux C, de la Loge C et al (2008) Strontium ranelate prevents quality of life impairment in post-menopausal women with established vertebral osteoporosis. Osteoporos Int 19:503-510
Roux C, Fechtenbaum J, Kolta S et al (2008) Strontium ranelate reduces the risk of vertebral fracture in young postmenopausal women with, severe osteoporosis. Ann. Rheum Dis 67:335-339
Drummond M, Barbieri M, Cook J et al (2009) Transferability of economic evaluations across juridictions: ISPOR good research practices task force report. Value Health [Epub Ahead of Print]