The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX.
CONCLUSIONS
The study estimated the cost-effectiveness of risedronate compared to no treatment in UK women using the FRAX algorithm for fracture risk assessment. A Markov cohort model was used to estimate the cost-effectiveness. Risedronate was found cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of 30,000 pounds.


BACKGROUND
The aim of this study was to assess the cost-effectiveness of risedronate for the prevention and treatment in a UK setting using the FRAX algorithm for fracture risk assessment. A further aim was to establish intervention thresholds with risedronate treatment.


METHODS
The cost-effectiveness of risedronate was compared to no treatment in post-menopausal women with clinical risk factors for fracture using a Markov cohort model populated with data relevant for the UK. The model incorporated the features of FRAX (the WHO risk assessment tool). The analysis had a health care perspective and quality adjusted life years was used as the main outcome measure.


RESULTS
Treatment was cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of 30,000 pounds. Treatment was also cost-effective at all ages in women who had previously sustained a fragility fracture or in women with a parental history of hip fracture with a bone mineral density set at the threshold of osteoporosis. At the 30,000 pounds threshold value for a QALY, risedronate was on average found to cost-effective below the 10-year probability of a major osteoporotic fractures of 13.0%.


CONCLUSIONS
Risedronate is a cost-effective agent for the treatment of established osteoporosis (osteoporosis and a prior fragility fracture) in women from the age of 50 years and older and above 65 years in women with osteoporosis alone. The results support the treatment recommendations in recent UK guidelines for osteoporosis.
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 V
EV
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; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000191:economics*; D058866:Osteoporotic Fractures / Q000191:economics* / Q000517:prevention & control; D011788:Quality of Life; D000068296:Risedronic Acid; D006113:United Kingdom
D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid