Cost effectiveness and cost utility of risedronate for osteoporosis treatment and fracture prevention in women: a Swiss perspective.
OBJECTIVE
To assess the incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) of risedronate compared to no intervention in postmenopausal osteoporotic women in a Swiss perspective.


METHODS
A previously validated Markov model was populated with epidemiological and cost data specific to Switzerland and published utility values, and run on a population of 1,000 women of 70 years with established osteoporosis and previous vertebral fracture, treated over 5 years with risedronate 35 mg weekly or no intervention (base case), and five cohorts (according to age at therapy start) with eight risk factor distributions and three lengths of residual effects.


RESULTS
In the base case population, the ICER of averting a hip fracture and the ICUR per quality-adjusted life year gained were both dominant. In the presence of a previous vertebral fracture, the ICUR was below euro45,000 (pound30,000) in all the scenarios. For all osteoporotic women>or=70 years of age with at least one risk factor, the ICUR was below euro45,000 or the intervention may even be cost saving. Age at the start of therapy and the fracture risk profile had a significant impact on results.


CONCLUSIONS
Assuming a 2-year residual effect, that ICUR of risedronate in women with postmenopausal osteoporosis is below accepted thresholds from the age of 65 and even cost saving above the age of 70 with at least one risk factor.
Wasserfallen
Jean-Blaise
JB
Lausanne University Hospital (CHUV), Lausanne, Switzerland. jbw@chuv.ch
Krieg
Marc-Antoine
MA
Greiner
Roger-Axel
RA
Lamy
Olivier
O
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000191:economics / Q000517:prevention & control*; D006801:Humans; D008390:Markov Chains; D055118:Medication Adherence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D019057:Quality-Adjusted Life Years; D000068296:Risedronic Acid; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000188:drug therapy* / Q000209:etiology; D013557:Switzerland
D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid