The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis.
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.
Borgström
F
F
Medical Management Centre, Karolinska Institute, Stockholm, Sweden. fredrik.borgstrom@i3innovus.com
Ström
O
O
Coelho
J
J
Johansson
H
H
Oden
A
A
McCloskey
E
E
Kanis
J A
JA
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
D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate