학술논문
Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain
Document Type
Report
Author
Source
ClinicoEconomics and Outcomes Research. January 1, 2013, Vol. 5, p327, 10 p.
Subject
Language
English
ISSN
1178-6981
Abstract
Introduction Osteoporosis is a frequently occurring disease in postmenopausal women, characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in increased bone fragility and fracture risk. (1,2) [...]
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. Conclusion: 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. Keywords: osteoporosis, bazedoxifene, raloxifene, vertebral, nonvertebral, fracture, efficacy, costs
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. Conclusion: 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. Keywords: osteoporosis, bazedoxifene, raloxifene, vertebral, nonvertebral, fracture, efficacy, costs