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


BACKGROUND
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 <or= -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 <or= -2.5 SD, the costs per QALY gained of strontium ranelate were respectively euro 15,096 euro and 6,913 euro at 70 and 75 years of age while these values were 23,426 euro and 9,698 euro for women with prevalent vertebral fractures. Sensitivity analyses showed that the results were robust over a wide range of assumptions.


CONCLUSIONS
This study suggested that, compared to no treatment, long-term strontium ranelate treatment is cost-effective for postmenopausal osteoporotic women.
Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. m.hiligsmann@ulg.ac.be
M
M
Hiligsmann
O
O
Bruyère
J-Y
JY
Reginster
D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D004812:Epidemiologic Methods; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000191:economics / Q000517:prevention & control; D019057:Quality-Adjusted Life Years; D013876:Thiophenes / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate