Ginsberg G, Shemer J; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2000; 16: 359.

Medical Technology Assessment Division, Ministry of Health, Ben Tbai 2, Jerusalem, Israel.

Introduction: This study is an economic evaluation of 3 drugs (HRT, Alendronate [ALN], Raloxifene [RLX]) used for prevention and treatment of osteoporosis. Methods: A spreadsheet model was constructed which included:- a) Age-specific Israeli population and life expectancy data. b) Pharmaceutical costs. c) Age-specific incidence rates and health service direct costs (ie: excluding work absences) by fracture type (Hip, Vertebral, Distal Radius and Proximal Humerus) and by potential pharmaceutical side effects (Cardiovascular Disease, Cerebrovascular Stroke, Alzheimer's Disease, Breast, Colonic and Endometrial Cancer). d) Drug specific relative risks (RR) by age and duration of taking the drug, which were based on numerous Meta-Analyses of all existing published literature. e) Age-specific Quality Adjusted Life Year Loss (QALY's) for each fracture type and potential side effect, which were based on calculations from the literature. Results: (Based on 5 years of continuous treatment). For women >59 yrs in the general-population, HRT is cost-saving, however QALY gains only surpass ALN & RLX in persons > 71 years. ALN and RLX become cost-saving in osteopaenics >71 years old. For osteoporotics, both ALN & RLX become cost-saving in women>69 years. In women<71 years old, RLX has a clear QALY advantage due to its protective effects vis-a-vis breast cancer & heart disease. After age 71, ALN has the highest QALY's. Conclusion: Since ""fear of cancer"" hinders HRT compliance, additional health promotion. Should aim to increase HRT use in the general population. The cost of providing ALN and RLX to osteo-paenics/porotics aged over 70 years respectively would be more than recovered in terms of decreased health services costs. In addition, benefits (Range: 0.23-0.74 QALY's) in terms of increased quality of life and decreased mortality will also accrue.

Publication Types:

• Meeting Abstracts

Keywords:

• Alendronate
• Estrogen Antagonists
• Female
• Fractures, Bone
• Hip
• Hormone Replacement Therapy
• Humans
• Israel
• Osteoporosis
• Quality-Adjusted Life Years
• Raloxifene
• Selective Estrogen Receptor Modulators
• drug therapy
• methods
• therapy
• hsrmtgs

Other ID:

• GWHSR0000128

UI: 102271802

From Meeting Abstracts