title: Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain.
abstract: BACKGROUND
  The purpose of this study was to assess the cost-effectiveness of bazedoxifene and raloxifene for prevention of vertebral and nonvertebral fractures among postmenopausal Spanish women aged 55-82 years with established osteoporosis and a high fracture risk.
  
  
  METHODS
  A Markov model was developed to represent the transition of a cohort of postmenopausal osteoporotic women through different health states, ie, patients free of fractures, patients with vertebral or nonvertebral fractures, and patients recovered from a fracture. Efficacy data for bazedoxifene were obtained from the Osteoporosis Study. The perspective of the Spanish National Health Service was chosen with a time horizon of 27 years. Costs were reported in 2010 Euros. Deterministic results were presented as expected cost per quality-adjusted life-year (QALY), and probabilistic results were represented in cost-effectiveness planes.
  
  
  RESULTS
  In deterministic analysis, the expected cost per patient was higher in the raloxifene cohort (€13,881) than in the bazedoxifene cohort (€13,436). QALYs gained were slightly higher in the bazedoxifene cohort (14.56 versus 14.54). Results from probabilistic sensitivity analysis showed that bazedoxifene has a slightly higher probability of being cost-effective for all threshold values independent of the maximum that the National Health Service is willing to pay per additional QALY.
  
  
  CONCLUSIONS
  Bazedoxifene was shown to be a cost-effective treatment option for the prevention of fractures in Spanish women with postmenopausal osteoporosis and a high fracture risk. When comparing bazedoxifene with raloxifene, it may be concluded that the former is the dominant strategy.
authors.affiliation: Universitat de Barcelona, Barcelona, Spain;
authors.forename: Josep
authors.initials: J
authors.lastname: Darbà
authors.forename: Nuria
authors.initials: N
authors.lastname: Pérez-Álvarez
authors.forename: Lisette
authors.initials: L
authors.lastname: Kaskens
authors.forename: Susana
authors.initials: S
authors.lastname: Holgado-Pérez
authors.forename: Jill
authors.initials: J
authors.lastname: Racketa
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
keywords: bazedoxifene; costs; efficacy; fracture; nonvertebral; osteoporosis; raloxifene; vertebral