Cost-Effectiveness of Risedronate Treatment for Preventing Osteoporotic Fractures in Swiss Postmenopausal Women



Matthias Bischof*, 1, 2, Marius Kränzlin3, Heiner C. Bucher1, Pedram Sendi1
1 Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland
2 PATH Research Institute, St. Joseph’s Healthcare McMaster University, Hamilton, ON, Canada
3 Division of Endocrinology and Metabolic Disorders, University Hospital Basel, Switzerland


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© Bischof et al.;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, CH-4031 Basel, Switzerland Tel: 41-61-265 3100; Fax: 41-61-265 3109; E-mail: bischof@mcmaster.ca


Abstract

Objective:

Osteoporosis is a major public health concern in Switzerland and is associated with an increased rate of bone factures, health care costs, mortality and loss of quality of life. Risedronate has been shown to effectively prevent fractures in patients with osteoporosis. We examined the cost-effectiveness of risedronate from the Swiss health care perspective for the treatment of osteoporosis in postmenopausal women.

Methods:

A probabilistic Markov model was developed to address this issue. Data for the treatment effect was derived from a meta-analysis and quality of life estimates were extracted from a systematic review. Costs were identified by using Swiss sources and expressed in Swiss Francs (CHF) for the year 2007.

Results:

Osteoporotic women 70 years of age with a T-score of -2.5 who are treated over 5 consecutive years with risedronate and vitamin D and calcium, experienced on average 0.064 additional QALYs (95% CI: 0.039 QALYs to 0.091 QALYs) compared to patients treated with vitamin D and calcium alone. Costs in the treatment group were CHF 4341 higher (95% CI: CHF 3,427 to CHF 5,123), yielding an incremental cost-effectiveness ratio (ICER) of CHF 67,681 (USD 63,330; ´44,620) per QALY. For women 70 years of age with a T-score of ≤-2.5 SD the ICER is CHF 13,428 per QALY

Conclusions:

Based on a decision analytic model the results of this economic evaluation suggest that risedronate in the Swiss setting is a cost-effective treatment for osteoporosis in 70-year-old females at the threshold of osteoporosis or with established osteoporosis.

Keywords: Systematic review, cost of illness, urinary incontinence, overactive bladder.