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Greater first year effectiveness drives favorable cost-effectiveness of brand risedronate versus generic or brand alendronate: modeled Canadian analysis

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Abstract

Summary

The RisedronatE and ALendronate (REAL) study provided a unique opportunity to conduct cost-effectiveness analyses based on effectiveness data from real-world clinical practice. Using a published osteoporosis model, the researchers found risedronate to be cost-effective compared to generic or brand alendronate for the treatment of Canadian postmenopausal osteoporosis in patients aged 65 years or older.

Introduction

The REAL study provides robust data on the real-world performance of risedronate and alendronate. The study used these data to assess the cost-effectiveness of brand risedronate versus generic or brand alendronate for treatment of Canadian postmenopausal osteoporosis patients aged 65 years or older.

Methods

A previously published osteoporosis model was populated with Canadian cost and epidemiological data, and the estimated fracture risk was validated. Effectiveness data were derived from REAL and utility data from published sources. The incremental cost per quality-adjusted life-year (QALY) gained was estimated from a Canadian public payer perspective, and comprehensive sensitivity analyses were conducted.

Results

The base case analysis found fewer fractures and more QALYs in the risedronate cohort, providing an incremental cost per QALY gained of $3,877 for risedronate compared to generic alendronate. The results were most sensitive to treatment duration and effectiveness.

Conclusions

The REAL study provided a unique opportunity to conduct cost-effectiveness analyses based on effectiveness data taken from real-world clinical practice. The analysis supports the cost-effectiveness of risedronate compared to generic or brand alendronate and the use of risedronate for the treatment of osteoporotic Canadian women aged 65 years or older with a BMD T-score ≤–2.5.

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Notes

  1. Health utility is a quantitative measure of heath-related quality of life that expresses the quality of life associated with a health state on a scale from 0 (dead) to 1 (perfect health).

  2. Once results were obtained, we found that applying the triangular distribution rather than the log normal distribution to risedronate changed each of the values specified in points 1) to 4) of this paragraph by less than one percentage point.

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Acknowledgements

Funding for the study was provided by the Alliance for Better Bone Health.

Disclosures of interest

Daniel Grima is a paid employee of and shareholder in Cornerstone Research Group, Inc. Cornerstone received funding to conduct the cost-effectiveness analysis and develop the manuscript. Cornerstone conducts other consulting activities for the Alliance for Better Bone Health and other pharmaceutical companies that market osteoporosis therapies.

Alexandra Papaioannou is or has been a consultant to the following companies: Amgen, Eli Lilly, Merck Frosst, Procter & Gamble, Sanofi-Aventis. Dr Papaioannou has conducted clinical trials for: Eli Lilly, Merck Frosst, Procter & Gamble, and Sanofi-Aventis.

Melissa Thompson is a paid employee of Cornerstone Research Group, Inc. Cornerstone received funding to conduct the cost-effectiveness analysis and develop the manuscript. Cornerstone conducts other consulting activities for the Alliance for Better Bone Health and other pharmaceutical companies that market osteoporosis therapies.

Margaret Pasquale is a paid employee of P&G Pharmaceuticals Inc., which is a member of the Alliance for Better Bone Health.

Jonathan D. Adachi is/has been a consultant/speaker for Amgen, Astra Zeneca, Eli Lilly, GSK, Merck, Novartis, Pfizer, Procter & Gamble, Roche, Sanofi-Aventis, and Servier. He has participated in clinical trials for Amgen, Eli Lilly, GSK, Merck, Novartis, Pfizer, Procter & Gamble, and Roche.

Author information

Authors and Affiliations

  1. Cornerstone Research Group Inc., 6–4380 South Service Road, Burlington, ON, L7L 5Y6, Canada

    D. T. Grima & M. F. Thompson

  2. Department of Medicine, McMaster University, Hamilton, ON, Canada

    A. Papaioannou & J. D. Adachi

  3. St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada

    A. Papaioannou & J. D. Adachi

  4. Procter & Gamble Pharmaceuticals, Mason, OH, USA

    M. K. Pasquale

Authors
  1. D. T. Grima
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  2. A. Papaioannou
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  3. M. F. Thompson
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  4. M. K. Pasquale
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  5. J. D. Adachi
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Correspondence to D. T. Grima.

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Grima, D.T., Papaioannou, A., Thompson, M.F. et al. Greater first year effectiveness drives favorable cost-effectiveness of brand risedronate versus generic or brand alendronate: modeled Canadian analysis. Osteoporos Int 19, 687–697 (2008). https://doi.org/10.1007/s00198-007-0504-z

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