title: The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis.
abstract: The cost-effectiveness of strontium ranelate was compared to no treatment in UK women using the FRAX algorithm for fracture risk assessment. At a willingness-to-pay of pound 30,000 per quality-adjusted life-year (QALY), strontium ranelate was generally cost-effective in women with prior fracture at the threshold of osteoporosis from an age of 65 years.
  
  
  BACKGROUND
  The objectives of the study were to estimate the cost-effectiveness of strontium ranelate in the UK for the treatment of osteoporosis and to establish intervention thresholds for treatment using the FRAX tool.
  
  
  METHODS
  The cost-effectiveness of strontium ranelate was compared to no treatment in postmenopausal women with clinical risk factors for fracture using a lifetime simulation model based on Markov cohort methodology that incorporated the features of FRAX.
  
  
  RESULTS
  At a threshold of pound 30,000 per QALY, strontium ranelate was generally cost-effective in women from an age of 65 years with prior fracture at the threshold of osteoporosis (i.e., a T-score of -2.5 SD) and in women with a prior fracture (and no information on bone mineral density) from the age of 65 years. At a threshold of pound 20,000, strontium ranelate became cost-effective at a 10-year fracture probability of 25.7% and at 16.9% with a threshold of pound 30,000 for a QALY.
  
  
  CONCLUSIONS
  Strontium ranelate is a cost-effective agent for the treatment of established osteoporosis in women over the age of 65 years. Cost-effective scenarios were also found for the prevention and treatment of fractures associated with osteoporosis, in younger women with additional clinical risk factors.
authors.affiliation: Medical Management Centre, Karolinska Institute, Stockholm, Sweden. fredrik.borgstrom@i3innovus.com
authors.forename: F
authors.initials: F
authors.lastname: Borgström
authors.forename: O
authors.initials: O
authors.lastname: Ström
authors.forename: J
authors.initials: J
authors.lastname: Coelho
authors.forename: H
authors.initials: H
authors.lastname: Johansson
authors.forename: A
authors.initials: A
authors.lastname: Oden
authors.forename: E
authors.initials: E
authors.lastname: McCloskey
authors.forename: J A
authors.initials: JA
authors.lastname: Kanis
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009942:Organometallic Compounds / Q000191:economics / Q000627:therapeutic use*; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013876:Thiophenes / Q000191:economics / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate