[en] OBJECTIVE: To estimate the cost-effectiveness of strontium ranelate in the treatment of postmenopausal osteoporotic women aged over 75 years. MATERIALS AND METHODS: A validated Markov microsimulation model with a Belgian payer's perspective estimated the cost per quality-adjusted life-year (QALY) of a 3-year strontium ranelate treatment compared with no treatment and with the bisphosphonate risedronate. Data on the effect of both treatments on fracture risk were taken from the Cochrane Database of Systematic Reviews. Analyses were performed for postmenopausal women aged 75 and 80 years, either with a diagnosis of osteoporosis (i.e. bone mineral density T-score
Disciplines :
Special economic topics (health, labor, transportation...) Rheumatology
Author, co-author :
Hiligsmann, Mickaël ; Université de Liège - ULiège > HEC-Ecole de gestion : UER > Economie industrielle
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Language :
English
Title :
Cost-effectiveness of strontium ranelate versus risedronate in the treatment of postmenopausal osteoporotic women aged over 75 years.
Johnell O., and Kanis J.A. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos. Int. 17 (2006) 1726-1733
Delmas P.D. Treatment of postmenopausal osteoporosis. Lancet 359 (2002) 2018-2026
Rabenda V., Mertens R., Fabri V., Vanoverloop J., Sumkay F., Vannecke C., et al. Adherence to bisphosphonates therapy and hip fracture risk in osteoporotic women. Osteoporos. Int. 19 (2008) 811-818
Marie P.J., Ammann P., Boivin G., and Rey C. Mechanisms of action and therapeutic potential of strontium in bone. Calcif. Tissue Int. 69 (2001) 121-129
Meunier P.J., Roux C., Seeman E., Ortolani S., Badurski J.E., Spector T.D., et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N. Engl. J. Med. 350 (2004) 459-468
Reginster J.Y., Felsenberg D., Boonen S., Diez-Perez A., Rizzoli R., Brandi M.L., et al. 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 (2008) 1687-1695
Reginster J.Y., Seeman E., De Vernejoul M.C., Adami S., Compston J., Phenekos C., et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J. Clin. Endocrinol. Metab. 90 (2005) 2816-2822
Seeman E., Devogelaer J.P., Lorenc R., Spector T., Brixen K., Balogh A., et al. Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia. J. Bone Miner. Res. 23 (2008) 433-438
Drummond M., Sculpher M., O'Brien B., Stoddart G., and Torrance G. Methods for the economic evaluation of health care programmes. 3rd edition (2007), Oxford Univ. Press, New-York
Borgstrom F., Jonsson B., Strom O., and Kanis J.A. 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 (2006) 1781-1793
Hiligsmann M., Bruyere O., and Reginster J.Y. Cost-utility of long-term strontium ranelate treatment for postmenopausal osteoporotic women. Osteoporos. Int. (2009) [electronic puhlication Ahead of Print]
Borgstrom F., Strom O., Coelho J., Johansson H., Oden A., McCloskey E., et al. The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis. Osteoporos. Int. (2009) [electronic puhlication Ahead of Print]
Mullins C.D., and Ogilvie S. Emerging standardization in pharmacoeconomics. Clin. Ther. 20 (1998) 1194-1202
Borgstrom F., and Kanis J.A. Health economics of osteoporosis. Best Pract. Res. Clin. Endocrinol. Metab. 22 (2008) 885-900
Boonen S., McClung M.R., Eastell R., El-Hajj Fuleihan G., Barton I.P., and Delmas P. Safety and efficacy of risedronate in reducing fracture risk in osteoporotic women aged 80 and older: implications for the use of antiresorptive agents in the old and oldest old. J. Am. Geriatr. Soc. 52 (2004) 1832-1839
McClung M.R., Geusens P., Miller P.D., Zippel H., Bensen W.G., Roux C., et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N. Engl. J. Med. 344 (2001) 333-340
Reginster J., Minne H.W., Sorensen O.H., Hooper M., Roux C., Brandi M.L., et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos. Int. 11 (2000) 83-91
Borgstrom F., Carlsson A., Sintonen H., Boonen S., Haentjens P., Burge R., et al. The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective. Osteoporos. Int. 17 (2006) 996-1007
Kanis J.A., Borgstrom F., Johnell O., and Jonsson B. Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos. Int. 15 (2004) 862-871
Brecht J.G., Kruse H.P., Felsenberg D., Mohrke W., Oestreich A., and Huppertz E. Pharmacoeconomic analysis of osteoporosis treatment with risedronate. Int. J. Clin. Pharmacol. Res. 23 (2003) 93-105
Hiligsmann M., Bruyere O., Ethgen O., Richy F., Gathon H.J., and Reginster J.Y. Development and validation of a Markov microsimulation model for the economic evaluation of treatments in osteoporosis. Value Health 12 (2009) 687-696
Hiligsmann M., Bruyere O., Ethgen O., Gathon H.J., and Reginster J.Y. Lifetime absolute risk of hip and other osteoporotic fracture in Belgian women. Bone 43 (2008) 991-994
Hiligsmann M., Bruyere O., Pire G., and Reginster J.Y. Economic evaluation of osteoporosis screening strategy conducted in the Province of Liege with the cooperation of Liege Province Sante. Rev. Med. Liege 63 (2008) 588-594
Hiligsmann M., Ethgen O., Bruyere O., and Reginster J.Y. An economic evaluation of quantitative ultrasonometry as pre-screening test for the identification of patients with osteoporosis. Dis. Manag. Health Outcomes 16 (2008) 429-438
Cleemput I., van Wilder P., Huybrechts M., and Vrijens F. Belgian methodological guidelines for pharmacoeconomic evaluations: toward standardization of drug reimbursement requests. Value Health 12 (2009) 441-449
Dere W., Avouac B., Boers M., Buxton M., Christiansen C., Dawson A., et al. 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 (1998) 93-97
Kanis J.A., Adams J., Borgstrom F., Cooper C., Jonsson B., Preedy D., et al. The cost-effectiveness of alendronate in the management of osteoporosis. Bone 42 (2008) 4-15
Autier P., Haentjens P., Bentin J., Baillon J.M., Grivegnee A.R., Closon M.C., et al. Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos. Int. 11 (2000) 373-380
Reginster J.Y., Gillet P., Ben Sedrine W., Brands G., Ethgen O., de Froidmont C., et al. Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15 (1999) 507-514
Gabriel S.E., Tosteson A.N., Leibson C.L., Crowson C.S., Pond G.R., Hammond C.S., et al. Direct medical costs attributable to osteoporotic fractures. Osteoporos. Int. 13 (2002) 323-330
Melton III L.J., Gabriel S.E., Crowson C.S., Tosteson A.N., Johnell O., and Kanis J.A. Cost-equivalence of different osteoporotic fractures. Osteoporos. Int. 14 (2003) 383-388
Zethraeus N., Borgstrom F., Strom O., Kanis J.A., and Jonsson B. Cost-effectiveness of the treatment and prevention of osteoporosis-a review of the literature and a reference model. Osteoporos. Int. 18 (2007) 9-23
Hiligsmann M., Ethgen O., Richy F., and Reginster J.Y. Utility values associated with osteoporotic fracture: a systematic review of the literature. Calcif. Tissue Int. 82 (2008) 288-292
Kanis J.A., Johnell O., Oden A., Jonsson B., De Laet C., and Dawson A. Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27 (2000) 585-590
Looker A.C., Wahner H.W., Dunn W.L., Calvo M.S., Harris T.B., Heyse S.P., et al. Updated data on proximal femur bone mineral levels of US adults. Osteoporos. Int. 8 (1998) 468-489
Marshall D., Johnell O., and Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312 (1996) 1254-1259
Johnell O., Kanis J.A., Oden A., Johansson H., De Laet C., Delmas P., et al. Predictive value of BMD for hip and other fractures. J. Bone Miner. Res. 20 (2005) 1185-1194
Klotzbuecher C.M., Ross P.D., Landsman P.B., Abbott III T.A., and Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J. Bone Miner. Res. 15 (2000) 721-739
Kanis J.A., Johnell O., De Laet C., Johansson H., Oden A., Delmas P., et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone 35 (2004) 375-382
O'Donnell S., Cranney A., Wells G.A., Adachi J.D., and Reginster J.Y. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database Syst. Rev. 3 (2008) CD005326
Wells G., Cranney A., Peterson J., Boucher M., Shea B.J., Robinson V., et al. Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst. Rev. 3 (2008) CD004523
Meunier P.J., Roux C., Ortolani S., Diaz-Curiel M., Compston J., Marquis P., et al. Effects of long-term strontium ranelate treatment on vertebral fracture risk in postmenopausal women with osteoporosis. Osteoporos. Int. (2009) [electronic puhlication Ahead of Print]
Stock J.L., Bell N.H., Chesnut III C.H., Ensrud K.E., Genant H.K., Harris S.T., et al. Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am. J. Med. 103 (1997) 291-297
Belgian Center for Pharmacotherapeutic Information. Available from URL: http://www.cbip.be/GGR/MPG/MPG_NJ.cfm#MP_2583. [Accessed 1 May 2009]
Belgian Center for Pharmacotherapeutic Information. Available from URL: http://www.cbip.be/GGR/MPG/MPG_NI.cfm#MP_04090. [Accessed 1 May 2009]
Gold M., Siegel J., Russell L., and MC. W. Cost-effectiveness in Health and Medecine (1996), Oxford Univ. Press, London
Cleemput I, Neyt M, Thiry N, De Laet C, Leys M. 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 100B (D/2008/10.273/95).
Raftery J. NICE: faster access to modern treatments? Analysis of guidance on health technologies. Br. Med. J. 323 (2001) 1300-1303
Fenwick E., O'Brien B.J., and Briggs A. Cost-effectiveness acceptability curves-facts, fallacies and frequently asked questions. Health Econ. 13 (2004) 405-415
Stevenson M., Davis S., Lloyd-Jones M., and Beverley C. The clinical effectiveness and cost-effectiveness of strontium ranelate for the prevention of osteoporotic fragility fractures in postmenopausal women. Health Technol. Assess. 11 (2007) 1-134
Reginster J.Y. Treatment of postmenopausal osteoporosis. BMJ 330 (2005) 859-860
Cranney A., Guyatt G., Griffith L., Wells G., Tugwell P., and Rosen C. Meta-analyses of therapies for postmenopausal osteoporosis. IX: summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr. Rev. 23 (2002) 570-578
Cranney A. Treatment of postmenopausal osteoporosis. BMJ 327 (2003) 355-356
