Cost-effectiveness of pharmacological fracture prevention for osteoporosis as prescribed in clinical practice in France, Germany, Italy, Spain, and the United Kingdom
Autor: | Peyman Hadji, E Hernlund, R Thoren, Eugene V. McCloskey, B. Stollenwerk, Axel Svedbom, R. Stad |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Cost effectiveness Endocrinology Diabetes and Metabolism Cost-Benefit Analysis Osteoporosis Population 030209 endocrinology & metabolism Drug Prescriptions Sensitivity and Specificity Drug Costs 03 medical and health sciences 0302 clinical medicine medicine Humans education health care economics and organizations Osteoporosis Postmenopausal Preventive healthcare Aged education.field_of_study Cost–benefit analysis Bone Density Conservation Agents business.industry Incidence Health Care Costs medicine.disease Quality-adjusted life year Clinical Practice Europe Family medicine Fracture prevention Female 030101 anatomy & morphology Quality-Adjusted Life Years business Models Econometric Osteoporotic Fractures |
Zdroj: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 30(9) |
ISSN: | 1433-2965 |
Popis: | This study estimated the cost-effectiveness of pharmacological fracture prevention as prescribed in the five largest European countries (EU5) using the IOF reference cost-effectiveness model. Pharmacological fracture prevention as prescribed in clinical practice was cost-saving (provided more QALYs at lower costs) compared to no treatment in each of the EU5. To estimate the real-world cost-effectiveness of pharmacological fracture prevention as prescribed in the five largest European countries by population size: France, Germany, Italy, Spain, and the United Kingdom (UK) (collectively EU5). We analyzed sales data on osteoporosis drugs in each of the EU5 to derive a hypothetical intervention that corresponds to the mix of osteoporosis medication prescribed in clinical practice. The costs for this treatment mix were obtained directly from the sales data, and the efficacy of the treatment mix was estimated by weighing the treatment-specific fracture risk reductions from a published meta-analysis. Subsequently, we estimated the cost-effectiveness using costs per quality adjusted life year (QALY) of the intervention compared to no treatment in each of the EU5 using the International Osteoporosis Foundation (IOF) reference cost-effectiveness model. The model population comprised postmenopausal women, mean age 72 years with established osteoporosis (T-score ≤ − 2.5) among whom 23.6% had a prevalent vertebral fracture. The model was populated with country-specific data from the literature. Pharmacological fracture prevention as prescribed in clinical practice was cost-saving (provided more QALYs at lower costs) compared to no treatment in each country. The findings were robust in scenario analyses. Pharmacological fracture prevention as prescribed in clinical practice is cost-saving in each of the EU5. Because of the under-diagnosis and under-treatment of post-menopausal osteoporosis, from a health economic perspective, further cost-savings may be reached by expanding treatment to those at increased risk of fracture currently not receiving any treatment. |
Databáze: | OpenAIRE |
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