Cost-effectiveness of strontium ranelate in the treatment of male osteoporosis.
The results of this study suggest that, under the assumption of same relative risk reduction of fractures in men as for women, strontium ranelate could be considered a cost-effective strategy compared with no treatment for the treatment of osteoporotic men from a Belgian healthcare payer perspective.


BACKGROUND
This study was conducted to estimate the cost-effectiveness of strontium ranelate in the treatment of osteoporotic men.


METHODS
A previously validated Markov microsimulation model was adapted to estimate the cost (<euro>2,010) per quality-adjusted life-year (QALY) gained of strontium ranelate compared with no treatment. Similar efficacy data on lumbar spine and femoral neck bone mineral density (BMD) between men with osteoporosis at high risk of fracture (MALEO Trial) and postmenopausal osteoporotic women (pivotal SOTI, TROPOS trials) supports the assumption, in the base-case analysis, of the same relative risk reduction of fractures in men as for women. Analyses were conducted, from a Belgian healthcare payer perspective, in the population from the MALEO Trial who is a men population with a mean age of 73 years, and BMD T-score ≤-2.5 or prevalent vertebral fracture (PVF).


RESULTS
In the MALEO population, strontium ranelate compared with no treatment was estimated at <euro>49,798 and <euro>25,584 per QALY gained using efficacy data from the intent-to-treat analysis and the per-protocol analysis including only adherent patients, respectively. In men with a BMD T-score ≤-2.5 or with PVF, the cost per QALY gained of strontium ranelate fall below thresholds of <euro>45,000 and <euro>25,000 per QALY gained based on efficacy data from the entire population of the clinical trial and from the per-protocol analyses, respectively.


CONCLUSIONS
The results of this study suggest that, under the assumption of same relative risk reduction of fractures in men as for women, strontium ranelate could be considered cost-effective compared with no treatment for male osteoporosis.
Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. m.hiligsmann@maastrichtuniversity.nl
M
M
Hiligsmann
W
W
Ben Sedrine
O
O
Bruyère
J-Y
JY
Reginster
D000368:Aged; D001530:Belgium / Q000453:epidemiology; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D017059:Models, Econometric; D010024:Osteoporosis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D019057:Quality-Adjusted Life Years; D013876:Thiophenes / Q000191:economics* / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D013876:Thiophenes; C081587:strontium ranelate