title: Greater first year effectiveness drives favorable cost-effectiveness of brand risedronate versus generic or brand alendronate: modeled Canadian analysis.
abstract: The RisedronatE and ALendronate (REAL) study provided a unique opportunity to conduct cost-effectiveness analyses based on effectiveness data from real-world clinical practice. Using a published osteoporosis model, the researchers found risedronate to be cost-effective compared to generic or brand alendronate for the treatment of Canadian postmenopausal osteoporosis in patients aged 65 years or older.
  
  
  BACKGROUND
  The REAL study provides robust data on the real-world performance of risedronate and alendronate. The study used these data to assess the cost-effectiveness of brand risedronate versus generic or brand alendronate for treatment of Canadian postmenopausal osteoporosis patients aged 65 years or older.
  
  
  METHODS
  A previously published osteoporosis model was populated with Canadian cost and epidemiological data, and the estimated fracture risk was validated. Effectiveness data were derived from REAL and utility data from published sources. The incremental cost per quality-adjusted life-year (QALY) gained was estimated from a Canadian public payer perspective, and comprehensive sensitivity analyses were conducted.
  
  
  RESULTS
  The base case analysis found fewer fractures and more QALYs in the risedronate cohort, providing an incremental cost per QALY gained of $3,877 for risedronate compared to generic alendronate. The results were most sensitive to treatment duration and effectiveness.
  
  
  CONCLUSIONS
  The REAL study provided a unique opportunity to conduct cost-effectiveness analyses based on effectiveness data taken from real-world clinical practice. The analysis supports the cost-effectiveness of risedronate compared to generic or brand alendronate and the use of risedronate for the treatment of osteoporotic Canadian women aged 65 years or older with a BMD T-score < or =-2.5.
authors.affiliation: Cornerstone Research Group Inc., Burlington, ON, L7L 5Y6, Canada. dgrima@cornerstone-research.com
authors.forename: D T
authors.initials: DT
authors.lastname: Grima
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.forename: M F
authors.initials: MF
authors.lastname: Thompson
authors.forename: M K
authors.initials: MK
authors.lastname: Pasquale
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000191:economics* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000191:economics* / Q000627:therapeutic use; D002170:Canada; D003362:Cost-Benefit Analysis; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D008954:Models, Biological; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D000068296:Risedronic Acid; D012720:Severity of Illness Index
chemical_list: D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate