SUMMARY: Treatment with
alendronate (
Fosamax) has been shown to significantly reduce the risk of
fragility fractures.
Cost-effectiveness of treatment was assessed in nine European countries in a
Markov model and was generally found to be
cost effective in women with a previous spine fracture. INTRODUCTION: Treatment with
alendronate (
Fosamax) reduces the risk of osteoporotic fractures at the spine,
hip and
wrist in women with and without
prevalent vertebral fracture.
Cost-effectiveness estimates in one country may not be applicable elsewhere due to differences in fracture risks, costs and
drug prices. The aim of this study was to assess the
cost-effectiveness of treating
postmenopausal women with
alendronate in nine European countries, comprising Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, and the UK. METHODS: A
Markov model was populated with data for the nine European populations. Effect of treatment was taken from the Fracture Intervention Trial, which recruited women with low BMD alone or with a
prior vertebral fracture. RESULTS: The cost per QALY gained of treating
postmenopausal women with
prior vertebral fractures ranged in the base case from "cost saving" in the Scandinavian countries to <euro>15,000 in Italy. Corresponding estimates for women without
prior vertebral fractures ranged from "cost saving" to <euro>40,000. CONCLUSIONS: In relation to thresholds generally used, the analysis suggests that
alendronate is very
cost effective in the treatment of women with previous
vertebral fracture, and in women without previous
vertebral fracture,
cost-effectiveness depends on the country setting, discount rates, and chosen monetary thresholds.
