Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Osteoporosis International
Erschienen in: Osteoporosis International 7/2006

01.07.2006 | Original Article

The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective

verfasst von: F. Borgström, Å. Carlsson, H. Sintonen, S. Boonen, P. Haentjens, R. Burge, O. Johnell, B. Jönsson, J. A. Kanis

Erschienen in: Osteoporosis International | Ausgabe 7/2006

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Risedronate, a bisphosphonate for treatment and prevention of osteoporosis, has been shown in several clinical trials to reduce the risk of fractures in postmenopausal women with osteoporosis. The cost-effectiveness of risedronate treatment has previously been evaluated within different country settings using different model and analysis approaches. The objective of this study was to assess the cost-effectiveness of risedronate in postmenopausal women in four European countries—Sweden, Finland, Spain, and Belgium—by making use of the same modelling framework and analysis setup.

Methods

A previously developed Markov cohort model for the evaluation of osteoporosis treatments was used to estimate the cost-effectiveness of risedronate treatment. For each country, the model was populated with local mortality, fracture incidence, and cost data. Hip fractures, clinical vertebral fractures, and wrist fractures were included in the model.

Results

The incremental cost per quality-adjusted life years (QALY) gained from a 5-year intervention with risedronate compared to “no intervention” in 70-year-old women at the threshold of osteoporosis [T-score = −2.5 based on National Health and Nutrition Examination Survey (NHANES) III data] and previous vertebral fracture was estimated to be €860, €19,532, €11,782, and €32,515 in Sweden, Finland, Belgium, and Spain, respectively. Among 70-year-old women at the threshold of osteoporosis without previous fracture the estimated cost per QALY gained ranged from €21,148 (Sweden) to €80,100 (Spain). The differences in cost-effectiveness between countries are mainly explained by different costs (fracture and treatment costs), fracture risks, and discount rates. Based on cost per QALY gained threshold values found in the literature, the study results indicated risedronate to be cost effective in the treatment of elderly women with established osteoporosis in all the included countries.

Conclusions

At a hypothetical threshold value of €40,000 per QALY gained, the results in this study indicate that risedronate is a cost-effective treatment in elderly women at the threshold of osteoporosis (i.e., a T-score of −2.5) with prevalent vertebral fractures in Sweden, Finland, Belgium, and Spain.
Literatur
1.
Cummings SR, Melton, LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767CrossRefPubMed
2.
Report on Osteoporosis in the European Community - Action for Prevention (1998). European Commission – Employment & Social Affairs
3.
Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238PubMedCrossRef
4.
5.
Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R (2000) Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 11:83–91CrossRefPubMed
6.
Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 282:1344–1352PubMedCrossRef
7.
McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340CrossRefPubMed
8.
Drummond M, O’Brien B, Stoddart G, Torrance G (1997) Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford
9.
Kanis JA, Borgstrom F, Johnell O, Jonsson B (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int 15:862–871CrossRefPubMed
10.
Borgstrom F, Zethraeus N (2003) Economic assessment based on a clinical study of risedronate. Fracture prevention in elderly women with osteoporosis is cost-effective. Lakartidningen 100:36–40PubMed
11.
Iglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Quart J Med 95:305–311
12.
Hart WM, Rubio-Terres C, Burrell A, Aristegui I, Escobar-Jimenez Y (2002) Análisis farmacoeconómico del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato. REEMO 11:97–104
13.
Brecht JG, Kruse HP, Felsenberg D, Mohrke W, Oestreich A, Huppertz E (2003) Pharmacoeconomic analysis of osteoporosis treatment with risedronate. Int J Clin Pharmacol Res 23:93–105PubMed
14.
Sonnenberg FA, Beck JR (1993) Markov models in medical decision making: a practical guide. Med Decis Making 13:322–338PubMedCrossRef
15.
Jonsson B, Christiansen C, Johnell O, Hedbrandt J, Karlsson G (1996) Cost-effectiveness of fracture prevention in established osteoporosis. Scand J Rheumatol Suppl 103:30–38PubMed
16.
Johnell O, Jonsson B, Jonsson L, Black D (2003) Cost effectiveness of alendronate (Fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314CrossRefPubMed
17.
Jonsson L, Borgstrom F, Zethraeus N (2003) Cost-effectiveness of alendronate treatment of osteoporosis in Denmark. An economic evaluation based on the Fracture Intervention Trial. Ugeskr Laeger 165:4112–4116PubMed
18.
Zethraeus N, Johannesson M, Jonsson B (1999) A computer model to analyze the cost-effectiveness of hormone replacement therapy. Int J Technol Assess Health Care 15:352–365PubMed
19.
Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001) Cost-effectiveness of preventing hip fracture in the general female population. Osteoporos Int 12:356–361CrossRefPubMed
20.
Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jonsson B (2002) Intervention thresholds for osteoporosis. Bone 31:26–31CrossRefPubMed
21.
Kanis JA, Johnell O, Oden A, Jonsson B, Dawson A, Dere W (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11:120–127CrossRefPubMed
22.
Tosteson AN, Jonsson B, Grima DT, O’Brien BJ, Black DM, Adachi JD (2001) Challenges for model-based economic evaluations of postmenopausal osteoporosis interventions. Osteoporos Int 12:849–857CrossRefPubMed
23.
Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674CrossRefPubMed
24.
Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805CrossRefPubMed
25.
Federaal Ministerie van Sociale Zaken, Volksgezondheid en Leefmilieu. Bestuur van de gezondheidszorgen. Commissie voor toezicht op en evaluatie van statistische gegevens die verband houden met de medische activiteiten in de ziekenhuizen. Rijksadministratif centrum. Brussel. Upon written request
26.
Statistiek NIvd. NIS-Dienst Verspreiding, Leuvenseweg 44, B-1000 Brussel. Upon written request
27.
Elffors I, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Lopes Vaz AA, Lyritis G et al. (1994) The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporos Int 4:253–263CrossRefPubMed
28.
Johnell O, Gullberg B, Kanis JA (1997) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7:138–144CrossRefPubMed
29.
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Br Med J 312:1254–1259
30.
Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef
31.
Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMedCrossRef
32.
Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed
33.
Cranney A, Tugwell P, Adachi J, Weaver B, Zytaruk N, Papaioannou A, Robinson V, Shea B, Wells G, Guyatt G (2002) Meta-analyses of therapies for postmenopausal osteoporosis. III. Meta-analysis of risedronate for the treatment of postmenopausal osteoporosis. Endocr Rev 23:517–523CrossRefPubMed
34.
Tonino RP, Meunier PJ, Emkey R, Rodriguez-Portales JA, Menkes CJ, Wasnich RD, Bone HG, Santora AC, Wu M, Desai R, Ross PD (2000) Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. Phase III Osteoporosis Treatment Study Group. J Clin Endocrinol Metab 85:3109–3115CrossRefPubMed
35.
Stock JL, Bell NH, Chesnut CH 3rd, Ensrud KE, Genant HK, Harris ST, McClung MR, Singer FR, Yood RA, Pryor-Tillotson S, Wei L, Santora AC 2nd (1997) Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am J Med 103:291–297CrossRefPubMed
36.
Watts N, Barton I, Olszynski W, McKeever C, McClung M, Grauer A (2005) Sustained reduction of vertebral fracture risk in the year after discontinuation of risedronate treatment. Osteoporos Int 16:[Abstract s40]
37.
38.
Läkemedelsförmånsnämndens allmänna råd (2003). Stockholm
39.
Rovira J, Antonanzas F (1995) Economic analysis of health technologies and programmes. A Spanish proposal for methodological standardisation. Pharmacoeconomics 8:245–252PubMedCrossRef
40.
41.
A proposal for methodological guidelines for economic evaluation of pharmaceuticals (1995) Belgian Society for Pharmacoepidemiology, Brussels
42.
Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427CrossRefPubMed
43.
44.
Statistical Yearbook of Finland (2003). Statistics Finland, Helsinki
45.
46.
Statistical Yearbook of Sweden (2004). Statistics Sweden, Stockholm
47.
Oden A, Dawson A, Dere W, Johnell O, Jonsson B, Kanis JA (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8:599–603CrossRefPubMed
48.
Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42CrossRefPubMed
49.
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473CrossRefPubMed
50.
Parker MJ, Anand JK (1991) What is the true mortality of hip fractures? Public Health 105:443–446CrossRefPubMed
51.
Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed
52.
Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561PubMedCrossRef
53.
Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882CrossRefPubMed
54.
Lundberg L, Johannesson M, Isacson D, Borgquist L (1999) Health state utilities in a general population in relation to age, gender and socioeconomic factors. Eur J Public Health 9:211–217CrossRef
55.
Kind P, Hardman G, Macron S, UK Population Norms for EQ-5D (1999) Centre for Health Economics, University of York, York
56.
Ohinmaa A, Sintonen H (1996) Quality of life of the Finnish population as measured by the EuroQol. Institut Universitari de Salut Publica de Catalunya, Barcelona
57.
58.
Zethraeus N, Borgström F, Johnell O, Kanis J, Jönsson B (2002) Costs and quality of life associated with osteoporosis related fractures - results from a Swedish survey. Working Paper Series in Economics and Finance, 512
59.
Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson B (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15:20–26PubMedCrossRef
60.
Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13:768–776CrossRefPubMed
61.
National Osteoporosis Foundation (1998) Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effective analysis. Osteoporos Int 8(Suppl 4):1–88
62.
Gabriel SE, Kneeland TS, Melton LJ 3rd, Moncur MM, Ettinger B, Tosteson AN (1999) Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 19:141–148PubMedCrossRef
63.
Cranny A, Coyle D, Wells G, Jolly E, Tugwell P (2001) The psychometric properties of patient preferences in osteoporosis. J Rheumatology 28:132–137
64.
Merlino LA, Bagchi I, Taylor TN, Utrie P, Chrischilles E, Sumner DR, Mudano A, Saag KG (2001) Preferences for fractures and other glucocorticoid-associated adverse events among rheumatoid arthritis patients. Med Decis Making 21:122–132CrossRefPubMed
65.
Hallberg I, Rosenqvist AM, Kartous L, Lofman O, Wahlstrom O, Toss G (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15:834–841CrossRefPubMed
66.
Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedCrossRef
67.
Tosteson AN, Gabriel SE, Grove MR, Moncur MM, Kneeland TS, Melton LJ 3rd (2001) Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos Int 12:1042–1049PubMedCrossRef
68.
Hall SE, Criddle RA, Comito TL, Prince RL (1999) A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture. Osteoporos Int 9:508–515CrossRefPubMed
69.
Jonsson B, Christiansen C, Johnell O, Hedbrandt J, Karlsson G (1996) Cost-effectiveness of fracture prevention in established osteoporosis. Scand J Rheumatol 103(Suppl):30–38; discussion 39–40PubMed
70.
Ekman M, Zethraeus N, Dahlstrom U, Hoglund C (2002) Cost-effectiveness of bisoprolol in chronic heart failure. Lakartidningen 99:646–650PubMed
71.
Sacristan JA, Oliva J, Del Llano J, Prieto L, Pinto JL (2002) What is an efficient health technology in Spain? Gac Sanit 16:334–343PubMed
72.
Raftery J (2001) NICE: faster access to modern treatments? Analysis of guidance on health technologies. Br Med J 323:1300–1303CrossRef
73.
Kanis JA, Jonsson B (2002) Economic evaluation of interventions for osteoporosis. Osteoporos Int 13:765–767CrossRefPubMed
74.
Macroeconomics and Health: investing in health for economic development. Report of the Commission on Macroeconomics and Health (2001) Geneva
75.
Hart W, Rubio-Terres C, Burrell A, Aristegui I, Escobar-Jimenez Y (2002) Análisis farmacoeconómico del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato. REEMO 11
76.
Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674CrossRefPubMed
77.
Zethraeus N, Stromberg L, Jonsson B, Svensson O, Ohlen G (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68:13–17PubMedCrossRef
78.
Sintonen H, Vokkolainen A, Alhava E (2002) Osteoporoottisten lonkkamurtumien taloudelliset ja elämänlaadulliset seuraukset. Stakes Aiheita 34–35
79.
Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnee AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int 11:373–380CrossRefPubMed
80.
StadsledningskontoretsRedovisningsstab (2003) Stockholms stads budgetavräkning 2002. Stadsledningskontorets Redovisningsstab, Stockholm
81.
Hujanen T (2003) Terveydenhuollon yksikkökustannukset Suomessa vuonna 2001 Stakes Aiheita 1/2003, Helsinki
82.
83.
Honorato J, Gomez-Outes A, Navarro-Quilis A, Martinez-Gonzalez J, Rocha E, Planes A (2004) Pharmacoeconomic analysis of bemiparin and enoxaparin as prophylaxis for venous thromboembolism in total knee replacement surgery. Pharmacoeconomics 22:885–894CrossRefPubMed
84.
85.
86.
87.
88.
Priser för södra sjukvårdsregionen - Vårdtjänster per klinik (2003) Universitetssjukhuset i Lund
89.
Osteoporosis in the European Community: A Call to Action: An audit of policy developments since 1998 (2001) International Osteoporosis Foundation
Metadaten
Titel
The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective
verfasst von
F. Borgström
Å. Carlsson
H. Sintonen
S. Boonen
P. Haentjens
R. Burge
O. Johnell
B. Jönsson
J. A. Kanis
Publikationsdatum
01.07.2006
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 7/2006
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0094-1

Weitere Artikel der Ausgabe 7/2006

Osteoporosis International 7/2006 Zur Ausgabe

Letter

Reply to the letter by W. Pluskiewicz

Original Article

Association of PLOD1 polymorphisms with bone mineral density in a population-based study of women from the UK

Original Article

Women with hip fracture have a greater rate of decline in bone mineral density than expected: another significant consequence of a common geriatric problem

Original Article

Targeted education improves the very low recognition of vertebral fractures and osteoporosis management by general internists

Original Article

Influence of baseline deformity definition on subsequent vertebral fracture risk in postmenopausal women

Original Article

Reductions in degree of mineralization and enzymatic collagen cross-links and increases in glycation-induced pentosidine in the femoral neck cortex in cases of femoral neck fracture

Arthropedia

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

Neu im Fachgebiet Orthopädie und Unfallchirurgie

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

15.04.2024 | Knie-TEP | Nachrichten

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

11.04.2024 | Spondyloarthritiden | Nachrichten

Zwei neue Alternativen zu TNF-Inhibitoren bei axSpA
weitere anzeigen

Update Orthopädie und Unfallchirurgie

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

Newsletter bestellen
Bildnachweise