Cost-Effectiveness of Alendronate and Risedronate for Primary Prevention of Fractures in Postmenopausal Women
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Abstract
Introduction: This study determined the cost-effectiveness of generic-priced Alendronate and original-priced Risedronate for the primary prevention of fractures in postmenopausal women from the healthcare provider perspective. Epidemiological, clinical efficacy, cost and utility data were obtained from literature review. Method: A Markov model with nine health states was applied to estimate total costs and effectiveness for eight age-groups (45, 50, 55, 60, 65, 70, 75 and 80 years and above) using a 10-year time horizon, 5-year duration of medication, 50% medication adherence and a linear reduction of residual effect of the medicines. One-way and probabilistic sensitivity analyses were conducted. Results: Incremental cost-effectiveness ratios (ICER) of Alendronate and Risedronate were higher than three times of Gross Domestic Product (GDP) per capita, ranging from 801,353 – 7,012,743 Baht/quality-adjusted life year (QALY) gained and 1,727,023 – 13,967,461 Baht/QALY gained respectively. If the prices of generic Alendronate and original Risedronate decreased by 60% and 80% respectively, these drugs would be cost-effective for those aged 75 years and older. In conclusion, the use of Alendronate and Risedronate for the primary prevention of fractures is not cost-effective for all age-groups of postmenopausal women. Cost-effectiveness analysis of these drugs for the secondary prevention should be further conducted.
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