Raloxifene more cost-effective than alendronate
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
A cost-effectiveness analysis of raloxifene, alendronate and conservative care in post-menopausal women with osteopenia shows that raloxifene is less costly and more effective than alendronate in reducing the risk of fractures.
by Martha Kerr
A cost-effectiveness analysis of raloxifene, alendronate and conservative care in post-menopausal women with osteopenia shows that raloxifene is less costly and more effective than alendronate in reducing the risk of fractures.
Investigators, led by Dr. Eric S. Meadows of Eli Lilly and Company of Indianapolis, Indiana, developed a model to assess cost and effectiveness of the three approaches to reducing fracture risk in post-menopausal osteopenia.
The investigators evaluated clinical scenarios for women ages 55 through 75 years, with bone mineral density (BMD) T-scores of -1.0 to -2.4. The risk of vertebral and nonvertebral fractures, invasive breast cancer and venous thromboembolism were all calculated. Cost-effectiveness was computed as dollars per quality-adjusted life years (QALYs) gained.
"At all ages of postmenopausal women studied, alendronate was both more expensive and less effective than raloxifene," Dr. Meadows told Reuters Health.
For women between 55 and 60 years old, with BMD T-scores of -1.8, raloxifene cost approximately $50,000 per QALY gained compared with conservative care. Raloxifene was less cost-effective for women 65 years or older.
Raloxifene's cost-effectiveness was primarily due to its prevention of invasive breast cancer as opposed to reduction in fracture risk.
"Results were most sensitive to the population's underlying risk of fracture and breast cancer, assumed efficacy and costs of treatment, and the discount rate," the authors write.
The findings are published in the April 17th issue of BioMed Central Women's Health.
"The optimal treatment decision for an individual patient will depend upon her unique profile of risks for various positive and negative outcomes," Dr. Meadows told Reuters Health.
"Conservative care, defined as calcium and vitamin D supplementation, could be the preferred treatment option for some osteopenic women with a relatively low risk of fractures. However, for many years now, raloxifene has been shown to effectively reduce the risk of osteoporosis in postmenopausal women."
"A prior published study addressed the cost-effectiveness of alendronate for women with osteopenia, which showed that alendronate would likely not be considered cost-effective for the treatment of women with osteopenia diagnosed on the basis of BMD alone," Dr. Meadows commented.
But he added: "Bone mineral density alone does not include all the known risks of fracture. In the near future, a tool from the World Health Organization (WHO) is expected to be available that includes other risk factors."
Source: Reuters
A cost-effectiveness analysis of raloxifene, alendronate and conservative care in post-menopausal women with osteopenia shows that raloxifene is less costly and more effective than alendronate in reducing the risk of fractures.
Investigators, led by Dr. Eric S. Meadows of Eli Lilly and Company of Indianapolis, Indiana, developed a model to assess cost and effectiveness of the three approaches to reducing fracture risk in post-menopausal osteopenia.
The investigators evaluated clinical scenarios for women ages 55 through 75 years, with bone mineral density (BMD) T-scores of -1.0 to -2.4. The risk of vertebral and nonvertebral fractures, invasive breast cancer and venous thromboembolism were all calculated. Cost-effectiveness was computed as dollars per quality-adjusted life years (QALYs) gained.
"At all ages of postmenopausal women studied, alendronate was both more expensive and less effective than raloxifene," Dr. Meadows told Reuters Health.
For women between 55 and 60 years old, with BMD T-scores of -1.8, raloxifene cost approximately $50,000 per QALY gained compared with conservative care. Raloxifene was less cost-effective for women 65 years or older.
Raloxifene's cost-effectiveness was primarily due to its prevention of invasive breast cancer as opposed to reduction in fracture risk.
"Results were most sensitive to the population's underlying risk of fracture and breast cancer, assumed efficacy and costs of treatment, and the discount rate," the authors write.
The findings are published in the April 17th issue of BioMed Central Women's Health.
"The optimal treatment decision for an individual patient will depend upon her unique profile of risks for various positive and negative outcomes," Dr. Meadows told Reuters Health.
"Conservative care, defined as calcium and vitamin D supplementation, could be the preferred treatment option for some osteopenic women with a relatively low risk of fractures. However, for many years now, raloxifene has been shown to effectively reduce the risk of osteoporosis in postmenopausal women."
"A prior published study addressed the cost-effectiveness of alendronate for women with osteopenia, which showed that alendronate would likely not be considered cost-effective for the treatment of women with osteopenia diagnosed on the basis of BMD alone," Dr. Meadows commented.
But he added: "Bone mineral density alone does not include all the known risks of fracture. In the near future, a tool from the World Health Organization (WHO) is expected to be available that includes other risk factors."
Source: Reuters
