title: Cost-minimization study comparing annual infusion of zoledronic acid or weekly oral alendronate in women with low bone mineral density.
abstract: Cost-minimization study to assess the annual direct costs of 2 antiresorptive strategies in postmenopausal women with low bone mineral densities (BMDs). Patients were randomly assigned to receive 70 mg of oral weekly alendronate or a 1-time 5mg of intravenous zoledronic acid. All medical and nonmedical direct costs were recorded for 1 yr. Student's t-test or the Chi-squared test was used. A total of 101 postmenopausal women were enrolled with a mean age of 58.3 ± 7.6 yr and a postmenopausal period of 13.5 ± 8.3 yr. A total of 50 patients completed 1 yr of alendronate and 51 patients received zoledronic acid. At baseline, no differences were seen between the 2 groups in anthropometric measures, comorbidities, and bone mineral density. The costs for medical attention for low bone mass were $81,532 (US Dollars) for the alendronate group and $69,251 for the zoledronic acid group; the cost per patient was $1631 in the alendronate group vs $1358 in the zoledronic acid group (p<0.0001). Therefore, zoledronic acid treatment provided an annual savings of 15% of the direct costs compared with oral alendronate treatment. Moreover, there was a significant increase in lumbar spine T-scores in the zoledronic acid group when compared with the alendronate group. Annual zoledronic acid infusion as an antiresorptive treatment in women with low BMD provides significant monetary savings when compared with weekly alendronate therapy for 1 yr. Zoledronic acid infusion is also linked to higher increase in BMD and compliance.
authors.affiliation: Division of Internal Medicine, Hospital Central Sur de PEMEX, Mexico City, Mexico.
authors.forename: Venice
authors.initials: V
authors.lastname: Chávez-Valencia
authors.affiliation: Division of Internal Medicine, Hospital Central Sur de PEMEX, Mexico City, Mexico; Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: César Alejandro
authors.initials: CA
authors.lastname: Arce-Salinas
authors.affiliation: Division of Internal Medicine, Hospital Central Sur de PEMEX, Mexico City, Mexico. Electronic address: fabespi@yahoo.com.
authors.forename: Fabricio
authors.initials: F
authors.lastname: Espinosa-Ortega
mesh_terms: D015502:Absorptiometry, Photon; D000284:Administration, Oral; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage* / Q000191:economics; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000191:economics*; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000191:economics; D003363:Cost Control; D004164:Diphosphonates / Q000008:administration & dosage* / Q000191:economics; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage* / Q000191:economics; D007262:Infusions, Intravenous; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000191:economics; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D014807:Vitamin D; D000077211:Zoledronic Acid; D002119:Calcium Carbonate; D019386:Alendronate
keywords: Bisphosphonates; low bone mass; medical economics; postmenopausal osteoporosis