Cost-effectiveness of five versus ten years of alendronate treatment prior to drug holiday for women with osteoporosis.
Osteoporos Int
; 31(7): 1273-1282, 2020 Jul.
Article
en En
| MEDLINE
| ID: mdl-32020265
ABSTRACT
We performed a cost-effectiveness analysis comparing 5 versus 10 years of alendronate treatment prior to 5-year drug holiday for US postmenopausal women with hip BMD T-scores between - 2.5 and - 3.5. We found that for most postmenopausal women 5 years of treatment prior to drug holiday is the more effective and cost-effective option. INTRODUCTION:
We performed a cost-effectiveness analysis to compare 5 versus 10 years of alendronate treatment prior to 5-year drug holiday for postmenopausal osteoporotic women.METHODS:
We created an individual-level state-transition microsimulation model to compare 3 treatment strategies for US postmenopausal women with osteoporosis and femoral neck BMD T-scores between - 2.5 and - 3.5 at baseline recurrent periods of 5 years of alendronate followed by 5 years of drug holiday (alendronate 5/5), recurrent periods of 10 years of alendronate followed by 5 years of drug holiday (alendronate 10/5), and no alendronate treatment.RESULTS:
Base-case analysis revealed for women initiating treatment at ages 50, 60, and 70, the alendronate 5/5 strategy dominated (was more effective and less costly than) the alendronate 10/5 strategy and no treatment. For women age 80, the alendronate 10/5 strategy dominated. When assuming a lower relative risk of nonvertebral fracture during years 6-10 of alendronate treatment than the base-case assumption, the alendronate 10/5 strategy became the most cost-effective strategy even at younger treatment initiation ages. Probabilistic sensitivity analysis results supported the base-case findings; for treatment initiation ages of 50, 60, and 70, the alendronate 5/5 strategy was favored, whereas for treatment initiation age of 80, the alendronate 10/5 strategy was favored; however, there was uncertainty in these findings.CONCLUSIONS:
After 5 years of alendronate treatment, younger postmenopausal women (ages 50-70) with osteoporosis would likely benefit from a drug holiday, whereas older women (age 80) are likely to benefit from treatment for 10 years before a drug holiday.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteoporosis
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Preparaciones Farmacéuticas
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Osteoporosis Posmenopáusica
/
Alendronato
/
Conservadores de la Densidad Ósea
Tipo de estudio:
Etiology_studies
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Health_economic_evaluation
/
Prognostic_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Año:
2020
Tipo del documento:
Article