Comparative cost-effectiveness of bazedoxifene and raloxifene in the treatment of postmenopausal osteoporosis in Europe, using the FRAX algorithm.

Abstract

UNLABELLED:

Bazedoxifene and raloxifene were evaluated in the treatment of postmenopausal osteoporosis from health economic perspective in Europe. Based on a computer-based algorithm calculating efficacy of the treatments, bazedoxifene appears to be a cost-effective strategy compared to raloxifene, particularly in patients at high fracture risk.

INTRODUCTION:

The purpose of this study was to compare cost-effectiveness of bazedoxifene and raloxifene in eight European countries: Belgium, France, Germany, Ireland, Italy, Spain, Sweden, and the UK.

METHODS:

The Fracture Risk Assessment Tool, which is a computer-based algorithm to calculate fracture probability using clinical risk factors alone or with bone mineral density, was incorporated in a Markov Tunnel model to evaluate cost-effectiveness of bazedoxifene 20 or 40 mg vs. raloxifene 60 mg in postmenopausal osteoporotic women. The efficacy of bazedoxifene and raloxifene for vertebral and non-vertebral fractures was measured as a function of the 10-year probability of a major osteoporotic fracture. The model estimated the incremental cost-effectiveness ratio and net monetary benefit (NMB) from a healthcare perspective, given the willingness to pay <euro>30,000.

RESULTS:

In postmenopausal osteoporotic women, bazedoxifene was a cost saving strategy compared to raloxifene in the countries studied. The median NMB of bazedoxifene compared to raloxifene increased monotonically with the 10-year fracture probability. In general, the median NMB became greater than 0 in women with 10-year probabilities of a major osteoporotic fracture between 5 and 10% or above. The impact on results by varying the assumptions in the model was examined in sensitivity analysis.

CONCLUSION:

Bazedoxifene appears to be a cost-effective strategy compared to raloxifene for the treatment of postmenopausal osteoporotic women in Europe, particularly in patients at high fracture risk.

• Authors: K Kim, A Svedbom, X Luo, S Sutradhar, J A Kanis
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 25 Issue 1 Pg. 325-37 (Jan 2014) ISSN: 1433-2965 [Electronic] England
• PMID: 24114398 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Density Conservation Agents
• Indoles
• Raloxifene Hydrochloride
• bazedoxifene

Topics

• Aged
• Algorithms
• Bone Density Conservation Agents (economics, therapeutic use)
• Cost-Benefit Analysis
• Decision Support Techniques
• Dose-Response Relationship, Drug
• Europe (epidemiology)
• Female
• Health Care Costs (statistics & numerical data)
• Health Services Research (methods)
• Humans
• Indoles (administration & dosage, economics, therapeutic use)
• Middle Aged
• Osteoporosis, Postmenopausal (drug therapy, economics, epidemiology)
• Osteoporotic Fractures (economics, epidemiology, prevention & control)
• Quality of Life
• Raloxifene Hydrochloride (economics, therapeutic use)
• Risk Assessment (methods)
• Sensitivity and Specificity