The cost-effectiveness of the treatment of high risk women with osteoporosis, hypertension and hyperlipidaemia in Sweden.
This paper assessed the cost-effectiveness of the treatment of high risk women with osteoporosis, hypertension and hyperlipidaemia in Sweden, using one model and a societal perspective. Cost-effective scenarios were found in all these chronic disorders. These findings are of relevance for decisions on the efficient allocation of health care resources.


BACKGROUND
There is a need to assess the cost-effectiveness (CE) of treatment of osteoporosis from a societal perspective and to relate this to the CE of interventions in other disease areas. This is of relevance for decisions on the efficient allocation of health care resources within and between disease areas. The purpose of the paper was to estimate the CE of the treatment and prevention of osteoporosis and to put that into the perspective of treating hypertension and hyperlipidaemia. The CE was assessed for different high risk female populations aged 50-80 years.


METHODS
The estimation of CE was based on a model populated with data for Sweden.


RESULTS
Compared to no intervention, a 5-year treatment of osteoporosis, hypertension, and hyperlipidaemia, is cost effective for most of the assessed high risk female populations. The cost per gained quality adjusted life year (QALY) for the treatment of a 70-year-old woman never exceeded SEK 330,000 (US$ 44,000), which is generally judged as an acceptable cost for a gained QALY.


CONCLUSIONS
The study demonstrates that it is possible to produce reliable estimates of the CE of treatments in different disease areas within the context of a single model.
Zethraeus
N
N
Centre for Health Economics, Stockholm School of Economics, P.O. Box 6501, S-113 83 Stockholm, Sweden. henz@hhs.se
Ström
O
O
Borgström
F
F
Kanis
J A
JA
Jönsson
B
B
D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D008875:Middle Aged; D017059:Models, Econometric; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D019821:Simvastatin / Q000627:therapeutic use; D013548:Sweden / Q000453:epidemiology
D000959:Antihypertensive Agents; D050071:Bone Density Conservation Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006852:Hydrochlorothiazide; D019821:Simvastatin; D019386:Alendronate