nach oben

Osteoporosis International

Erschienen in:

01.10.2011 | Consensus Statement

Partial adherence: a new perspective on health economic assessment in osteoporosis

verfasst von: J. A. Kanis, C. Cooper, M. Hiligsmann, V. Rabenda, J-Y. Reginster, R. Rizzoli

Erschienen in: Osteoporosis International | Ausgabe 10/2011

Einloggen, um Zugang zu erhalten

Abstract

Summary

Partial adherence in osteoporosis increases the risk for fragility fracture and has considerable impact on cost-effectiveness. This review highlights a number of avenues for further research, such as improved definition of thresholds of compliance and persistence, as well as gap length, offset times, and fraction of benefit.

Introduction

A number of economic models have been developed to evaluate osteoporosis therapies and support decisions regarding efficient allocation of health care resources. Adherence to treatment is seldom incorporated in these models, which may reduce their validity for decision-making since adherence is poor in real-world clinical practice.

Methods

An ad hoc working group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review key issues concerning the incorporation of partial adherence in health economic models.

Results

Observational data have shown that poor adherence is associated with an increase in the risk for fragility fracture. Health economic modelling indicates that full adherence is associated with more quality-adjusted life years gained than partial adherence, as well as higher treatment costs and lower fracture-related costs. Although adherence appears as an important driver of cost-effectiveness, the effect is dependent on a range of other variables, such as offset time, fraction of benefit, fracture risk, fracture efficacy, fracture-related costs, and drug cost, some of which are poorly defined. Current models used to evaluate cost-effectiveness in osteoporosis may oversimplify the contributions of compliance and persistence.

Conclusion

Partial adherence has a significant impact on cost-effectiveness. Further research is required to optimise thresholds of compliance and persistence, the impact of gap length, offset times, and fraction of benefit.

International Osteoporosis Foundation (2009) Facts and statistics about osteoporosis and its implications. www.iofbonehealth.org/facts-and-statistics.html. Accessed 10 August 2009

Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238PubMedCrossRef

Borgstrom F, Kanis JA (2008) Health economics of osteoporosis. Best Pract Res Clin Endocrinol Metab 22:885–900PubMedCrossRef

Zethraeus N, Borgstrom F, Strom O et al (2007) Cost-effectiveness of the treatment and prevention of osteoporosis–a review of the literature and a reference model. Osteoporos Int 18:9–23PubMedCrossRef

Strom O, Borgstrom F, Kanis JA et al (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20:23–34PubMedCrossRef

Kanis JA, Jonsson B (2002) Economic evaluation of interventions for osteoporosis. Osteoporos Int 13:765–767PubMedCrossRef

Kanis JA, Adams J, Borgstrom F et al (2008) The cost-effectiveness of alendronate in the management of osteoporosis. Bone 42:4–15PubMedCrossRef

Kanis JA, Oden A, Johansson H et al (2009) FRAX and its applications to clinical practice. Bone 44:734–743PubMedCrossRef

Cramer JA, Roy A, Burrell A et al (2008) Medication compliance and persistence: terminology and definitions. Value Health 11:44–47PubMedCrossRef

10.

Lekkerkerker F, Kanis JA, Alsayed N et al (2007) Adherence to treatment of osteoporosis: a need for study. Osteoporos Int 18:1311–1317PubMedCrossRef

11.

Kendler DL, Ringe JD, Ste-Marie LG et al (2009) Risedronate dosing before breakfast compared with dosing later in the day in women with postmenopausal osteoporosis. Osteoporos Int 20:1895–1902PubMedCrossRef

12.

Cooper A, Drake J, Brankin E (2006) Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract 60:896–905PubMedCrossRef

13.

Schousboe JT, Dowd BE, Davison ML et al (2010) Association of medication attitudes with non-persistence and non-compliance with medication to prevent fractures. Osteoporos Int 21:1899–1909PubMedCrossRef

14.

Gallagher AM, Rietbrock S, Olson M et al (2008) Fracture outcomes related to persistence and compliance with oral bisphosphonates. J Bone Miner Res 23:1569–1575PubMedCrossRef

15.

Borgstrom F, Strom O, Coelho J et al (2010) The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis. Osteoporos Int 21:339–349PubMedCrossRef

16.

Borgstrom F, Strom O, Coelho J et al (2010) The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX. Osteoporos Int 21:495–505PubMedCrossRef

17.

Jonsson B, Strom O, Eisman JA et al (2011) Cost-effectiveness of denosumab for the treatment of postmenopausal osteoporosis. Osteoporos Int 22:967–982PubMedCrossRef

18.

Clowes JA, Peel NF, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 89:1117–1123PubMedCrossRef

19.

Rossini M, Bianchi G, Di MO et al (2006) Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int 17:914–921PubMedCrossRef

20.

Ziller V, Wetzel K, Kyvernitakis I et al (2010) Adherence and persistence in patients with postmenopausal osteoporosis treated with raloxifene. Climacteric 14:228–235PubMedCrossRef

21.

Huas D, Debiais F, Blotman F et al (2010) Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment. BMC Womens Health 10:26PubMedCrossRef

22.

Alegre P, Arnould B, Spizak C et al. (2010) Use of qualitative research to identify determinants of persistence for anti-osteoporotic treatments. Presented at the 13th ISPOR Annual European Conference, Prague, Czech Republic, 6–9 November 2010

23.

Reginster JY, Felsenberg D, Cooper C et al (2006) A new concept for bisphosphonate therapy: a rationale for the development of monthly oral dosing of ibandronate. Osteoporos Int 17:159–166PubMedCrossRef

24.

Silverman SL, Schousboe JT, Gold DT (2011) Oral bisphosphonate compliance and persistence: a matter of choice? Osteoporos Int 22:21–26PubMedCrossRef

25.

Cramer JA, Gold DT, Silverman SL et al (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int 18:1023–1031PubMedCrossRef

26.

Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928PubMedCrossRef

27.

Landfeldt E, Borgstrom F, Robbins S et al (2010) Adherence to treatment of osteoporosis in Sweden: The Swedish Adherence Register Analysis (SARA). P605. Osteoporos Int 21(suppl 1):S252

28.

Li L, Roddam A, Gitlin M et al (2010) Retrospective analysis of persistence to anti-osteoporosis medications in the UK General Practice Research Database. P606. Osteoporos Int 21(suppl 1):S252

29.

Breart G, Jakob FJ, Palacios S et al (2010) New interim analysis of a prospective observational cohort study of patients treated wth strontium ranelate. P416. Osteoporos Int 21(suppl 1):S166

30.

Rabenda V, Hiligsmann M, Reginster JY (2009) Poor adherence to oral bisphosphonate treatment and its consequences: a review of the evidence. Expert Opin Pharmacother 10:2303–2315PubMedCrossRef

31.

Siris ES, Selby PL, Saag KG et al (2009) Impact of osteoporosis treatment adherence on fracture rates in North America and Europe. Am J Med 122:S3–S13PubMedCrossRef

32.

Siris ES, Harris ST, Rosen CJ et al (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022PubMedCrossRef

33.

Rabenda V, Mertens R, Fabri V et al (2008) Adherence to bisphosphonates therapy and hip fracture risk in osteoporotic women. Osteoporos Int 19:811–818PubMedCrossRef

34.

Rabenda V, Reginster JY (2010) Positive impact of compliance to strontium ranelate on the risk of nonvertebral osteoporotic fractures. Osteoporos Int 21:1993–2002PubMedCrossRef

35.

Simpson SH, Eurich DT, Majumdar SR et al (2006) A meta-analysis of the association between adherence to drug therapy and mortality. BMJ 333:15PubMedCrossRef

36.

Curtis JR, Delzell E, Chen L et al. (2010) The relationship between bisphosphonate adherence and fracture: Is it the behavior or the medication? Results from the placebo arm of the fracture intervention trial. J Bone Miner Res (in press)

37.

McCloskey E, deTakats D, Orgee J et al (2005) Characteristics associated with non-persistence during daily therapy - experience from the placebo wing of a community-based clinical trial. J Bone Miner Res 20(suppl):S282

38.

Weycker D, Macarios D, Edelsberg J et al (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 17:1645–1652PubMedCrossRef

39.

Hiligsmann M, Rabenda V, Gathon HJ et al (2010) Potential clinical and economic impact of nonadherence with osteoporosis medications. Calcif Tissue Int 86:202–210PubMedCrossRef

40.

Hiligsmann M, Rabenda V, Bruyere O et al (2010) The clinical and economic burden of non-adherence with oral bisphosphonates in osteoporotic patients. Health Policy 96:170–177PubMedCrossRef

41.

Hiligsmann M, Gathon HJ, Bruyere O et al (2010) Cost-effectiveness of osteoporosis screening followed by treatment: the impact of medication adherence. Value Health 13:394–401PubMedCrossRef

42.

Ivergard M, Strom O, Borgstrom F et al (2010) Identifying cost-effective treatment with raloxifene in postmenopausal women using risk algorithms for fractures and invasive breast cancer. Bone 47:966–974PubMedCrossRef

43.

Stevenson M, Jones ML, De NE et al (2005) A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess 9:1–160PubMed

44.

Kanis JA, McCloskey EV, Jonsson B et al (2010) An evaluation of the NICE guidance for the prevention of osteoporotic fragility fracture in postmenopausal women. Arch Osteoporos 5:19–48CrossRef

45.

Cotte FE, Fardellone P, Mercier F et al (2010) Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis. Osteoporos Int 21:145–155PubMedCrossRef

Titel: Partial adherence: a new perspective on health economic assessment in osteoporosis
verfasst von: J. A. Kanis
C. Cooper
M. Hiligsmann
V. Rabenda
J-Y. Reginster
R. Rizzoli
Publikationsdatum: 01.10.2011
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 10/2011
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-011-1668-0

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Summary

Introduction

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2011

Effects of calcium-fortified ice cream on markers of bone health

Polymorphisms of the peroxisome proliferator-activated receptor γ (PPARγ) gene are associated with osteoporosis

Skeletal mineralization defects in adult hypophosphatasia—a clinical and histological analysis

Performance of comorbidity measures for predicting outcomes in population-based osteoporosis cohorts

Pubertal timing and body mass index gain from birth to maturity in relation with femoral neck BMD and distal tibia microstructure in healthy female subjects