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The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX®

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Abstract

Summary

The study estimated the cost-effectiveness of risedronate compared to no treatment in UK women using the FRAX algorithm for fracture risk assessment. A Markov cohort model was used to estimate the cost-effectiveness. Risedronate was found cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of £30,000.

Introduction

The aim of this study was to assess the cost-effectiveness of risedronate for the prevention and treatment in a UK setting using the FRAX® algorithm for fracture risk assessment. A further aim was to establish intervention thresholds with risedronate treatment.

Methods

The cost-effectiveness of risedronate was compared to no treatment in post-menopausal women with clinical risk factors for fracture using a Markov cohort model populated with data relevant for the UK. The model incorporated the features of FRAX® (the WHO risk assessment tool). The analysis had a health care perspective and quality adjusted life years was used as the main outcome measure.

Results

Treatment was cost-effective from the age of 65 years, assuming a willingness to pay for a QALY of £30,000. Treatment was also cost-effective at all ages in women who had previously sustained a fragility fracture or in women with a parental history of hip fracture with a bone mineral density set at the threshold of osteoporosis. At the £30,000 threshold value for a QALY, risedronate was on average found to cost-effective below the 10-year probability of a major osteoporotic fractures of 13.0%.

Conclusions

Risedronate is a cost-effective agent for the treatment of established osteoporosis (osteoporosis and a prior fragility fracture) in women from the age of 50 years and older and above 65 years in women with osteoporosis alone. The results support the treatment recommendations in recent UK guidelines for osteoporosis.

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Acknowledgement

We are grateful to Alliance for Better Bone Health for their financial support of this study.

Conflicts of interest

JAK, FB, OS, EMcC, HJ and AO act as advisors to and have received funding from many pharmaceutical companies involved in marketing products for treatment of osteoporosis.

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Authors and Affiliations

  1. Medical Management Centre, Karolinska Institute, Stockholm, Sweden

    F. Borgström & O. Ström

  2. I3 Innovus, Klarabergsviadukten 90, Hus D, 111 60, Stockholm, Sweden

    F. Borgström, O. Ström & J. Coelho

  3. Centre for Metabolic Bone Diseases (WHO Collaborating Centre) University of Sheffield Medical School, Sheffield, UK

    H. Johansson, A. Oden, E. V. McCloskey & J. A. Kanis

Authors
  1. F. Borgström
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  2. O. Ström
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  3. J. Coelho
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  4. H. Johansson
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  5. A. Oden
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  6. E. V. McCloskey
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  7. J. A. Kanis
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Correspondence to F. Borgström.

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Borgström, F., Ström, O., Coelho, J. et al. The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX®. Osteoporos Int 21, 495–505 (2010). https://doi.org/10.1007/s00198-009-0989-8

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  • DOI: https://doi.org/10.1007/s00198-009-0989-8

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