IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v26y2006i2p194-206.html
   My bibliography  Save this article

Cost-Effectiveness of Osteoporosis Screening and Treatment with Hormone Replacement Therapy, Raloxifene, or Alendronate

Author

Listed:
  • Lee R. Mobley

    (Division for Health Services and Social Policy Research, RTI International (Research Triangle Institute), 3040 Cornwallis Road, Research Triangle Park, NC 27709 lmobley@rti.org)

  • Thomas J. Hoerger
  • John S. Wittenborn

    (RTI International, Research Triangle Park, North Carolina)

  • Deborah A. Galuska
  • Jaya K. Rao

    (Centers for Disease Control and Prevention, Atlanta, Georgia)

Abstract

Recent information about osteoporosis treatments and their nonfracture side effects suggests the need for a new costeffectiveness analysis. The authors estimate the cost effectiveness of screening women for osteoporosis at age 65 and treating those who screen positive with hormone replacement therapy (HRT), raloxifene, or alendronate. A Markov model of osteoporosis disease progression simulates costs and outcomes of women aged 65 years. Incremental cost effectiveness ratios of screen-and-treat strategies are calculated relative to a no-screen, no-treat (NST) strategy. Disease progression parameters are derived from clinical trials; cost and quality-of-life parameters are based on review of cost databases and cost-effectiveness studies. Women are screened using dual-energy x-ray absorptiometry, and women screening positive are treated with HRT, raloxifene, or alendronate. Screening and treatment with HRT increase costs and lower quality-adjusted life years (QALYs; relative to the NST strategy). The only scenario (of several) in the sensitivity analysis in which HRT increases QALYs is when it is assumed that there are no drug-related (nonfracture) health effects. Raloxifene increases costs and QALYs; its cost-effectiveness ratio is $447,559 per QALY. When prescribed for the shortest duration modeled, raloxifene’s cost-effectiveness ratio approached $133,000 per QALY. Alendronate is the most cost-effective strategy; its cost-effectiveness ratio is $72,877 per QALY. Alendronate’s cost-effectiveness ratio approaches $55,000 per QALY when treatment effects last for 5 years or the discount rate is set to zero. The authors conclude that screening and treating with alendronate are more costeffective than screening and treating with raloxifene or HRT. Relative to an NST strategy, alendronate has a fairly good cost-effectiveness ratio

Suggested Citation

  • Lee R. Mobley & Thomas J. Hoerger & John S. Wittenborn & Deborah A. Galuska & Jaya K. Rao, 2006. "Cost-Effectiveness of Osteoporosis Screening and Treatment with Hormone Replacement Therapy, Raloxifene, or Alendronate," Medical Decision Making, , vol. 26(2), pages 194-206, March.
  • Handle: RePEc:sae:medema:v:26:y:2006:i:2:p:194-206
    DOI: 10.1177/0272989X06286478
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X06286478
    Download Restriction: no

    File URL: https://libkey.io/10.1177/0272989X06286478?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rachael Fleurence & Cynthia Iglesias & Jeanene Johnson, 2007. "The Cost Effectiveness of Bisphosphonates for the Prevention and Treatment of Osteoporosis," PharmacoEconomics, Springer, vol. 25(11), pages 913-933, November.
    2. Smita Nayak & Mark S Roberts & Susan L Greenspan, 2012. "Impact of Generic Alendronate Cost on the Cost-Effectiveness of Osteoporosis Screening and Treatment," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-7, March.
    3. Björn Stollenwerk & Afschin Gandjour & Markus Lüngen & Uwe Siebert, 2013. "Accounting for increased non-target-disease-specific mortality in decision-analytic screening models for economic evaluation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 1035-1048, December.
    4. Dirk Mueller & Afschin Gandjour, 2011. "Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis," Applied Health Economics and Health Policy, Springer, vol. 9(4), pages 259-273, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:26:y:2006:i:2:p:194-206. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.