Efficacy and cost-effectiveness of alendronate for the prevention of fractures in postmenopausal women in Norway

Background: The Norwegian guidelines for prevention and treatment of osteoporosis and osteoporosis-related fractures recommend treatment with bisphosphonates for women with T-score less than -1.6 and previous fractures and also for women with T-score less than or equal to -2.5 without previous fract...

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Bibliographic Details
Main Author: Hagen, Gunhild
Corporate Author: Nasjonalt kunnskapssenter for helsetjenesten
Format: eBook
Language:English
Published: Oslo Norwegian Knowledge Centre for the Health Services 2011, 2011
Series:Report from Kunnskapssenteret
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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100 1 |a Hagen, Gunhild 
245 0 0 |a Efficacy and cost-effectiveness of alendronate for the prevention of fractures in postmenopausal women in Norway  |h Elektronische Ressource  |c Gunhild Hagen [and nine others] 
246 3 1 |a Effekt og kostnadseffektivitet av alendronat i forebygging av brudd hos postmenopausale kvinner i Norge 
260 |a Oslo  |b Norwegian Knowledge Centre for the Health Services  |c 2011, 2011 
300 |a 1 PDF file (111 pages)  |b illustrations 
505 0 |a Includes bibliographical references 
653 |a Osteoporosis, Postmenopausal / prevention & control 
653 |a Alendronate / economics 
653 |a Cost-Benefit Analysis 
653 |a Fractures, Bone / prevention & control 
653 |a Treatment Outcome 
653 |a Alendronate / therapeutic use 
653 |a Osteoporosis, Postmenopausal / drug therapy 
653 |a Fractures, Bone / drug therapy 
653 |a Norway 
710 2 |a Nasjonalt kunnskapssenter for helsetjenesten 
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989 |b NCBI  |a National Center for Biotechnology Information 
490 0 |a Report from Kunnskapssenteret 
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520 |a Background: The Norwegian guidelines for prevention and treatment of osteoporosis and osteoporosis-related fractures recommend treatment with bisphosphonates for women with T-score less than -1.6 and previous fractures and also for women with T-score less than or equal to -2.5 without previous fracture. Only women with T-score equal to or less than -2.5 who have previous fractures will have their drug expenses reimbursed. The guideline was last revised in 2005. Since then, the price of alendronate has been reduced by 80%. The University of Oslo has asked the Norwegian Knowledge Centre for the Health Services to evaluate how this price reduction affects the cost-effectiveness of alendronate. Methods: We developed a model based economic evaluation with a lifetime perspective. The model follows a hypothetical cohort of women with respect to fractures of the hip, spine and wrist, late effects after fractures and mortality. During the course of the model costs and health effects are accumulated as a result of the fractures. Half of the women receive treatment with a combination of alendronate, calcium and vitamin D. The other half only receives calcium and vitamin D. The estimated efficacy of alendronate in combination with calcium and vitamin D compared to calcium and vitamin D only was based on a systematic review of the literature. Conclusions:1. Alendronate is likely to be a cost-effective alternative for women aged 65 and 75 years old with a T-score of equal to or less than -2.5 with no previous fracture and for women with a T-score of equal to or less than -2.0 who has suffered a previous fracture.2. The scarcity of efficacy data for women with a T-score above -2.5 without a previous fracture makes the inferences for these groups very uncertain