title: Cost-utility and budget impact analysis of primary prevention with alendronate of osteoporotic hip fractures in Catalonia.
abstract: OBJECTIVE
  To determine whether primary drug prevention of osteoporotic hip fracture is a useful measure in Catalonia and what would be their budgetary impact.
  
  
  METHODS
  We performed a cost-utility social perspective study with a time horizon of 10 to 20 years. Univariate sensitivity analysis was performed. Doing nothing is compared with an intervention that includes screening for osteoporosis in women> 64 years and in those diagnosed and who received treatment with generic alendronate for 10 years. Decision trees are developed for groups of 65-69, 70-74 and 75-79. HF data is from 2009 hospital discharges .Costs are derived from fees paid by public insurance.
  
  
  RESULTS
  In 2009 there were 9262 HF. The direct cost was € 55 million (€ 5,943.4/patient). The total cost was € 227 million for 10 years. The intervention dominates in all age groups in a 20 year perspective. In any horizon and age group, the different scenario puts the value per QALY below or within the proposed values for Spain. The budgetary impact is estimated at € 8.9 million which increased by 31% the actual direct cost, and 0.5% of the public pharmacy budget. Considering the total costs and the prospect of 20 years, annual savings of 7.4 million € were seen.
  
  
  CONCLUSIONS
  The prevention of HF with alendronate in osteoporotic women>64 years is cost-useful in the long term (20 years) with a low budgetary impact in the 75-79 year group.
authors.affiliation: Plan director de enfermedades reumáticas y del aparato locomotor, Departament de Salut, Generalitat de Catalunya, Barcelona, España. mjpueyo@catsalut.cat
authors.forename: María J
authors.initials: MJ
authors.lastname: Pueyo
authors.forename: Marta
authors.initials: M
authors.lastname: Larrosa
authors.forename: Xavier
authors.initials: X
authors.lastname: Surís
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Garcia-Ruiz
mesh_terms: D000368:Aged; D019386:Alendronate / Q000191:economics* / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000191:economics* / Q000627:therapeutic use; D002017:Budgets; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D016527:Drug Costs; D005260:Female; D006620:Hip Fractures / Q000191:economics / Q000517:prevention & control*; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis / Q000191:economics; D058866:Osteoporotic Fractures / Q000191:economics / Q000517:prevention & control*; D011322:Primary Prevention / Q000191:economics* / Q000379:methods; D013030:Spain
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate