Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain
Authors Darbà J, Pérez-Álvarez N, Kaskens L, Holgado-Pérez S, Racketa J, Rejas J
Received 14 January 2013
Accepted for publication 1 March 2013
Published 5 July 2013 Volume 2013:5 Pages 327—336
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Josep Darbà,1 Nuria Pérez-Álvarez,2 Lisette Kaskens,2 Susana Holgado-Pérez,3 Jill Racketa,4 Javier Rejas5
1Universitat de Barcelona, Barcelona, Spain; 2BCN Health Economics and Outcomes Research, Barcelona, Spain; 3Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; 4Global Health Economics and Outcomes Research, Pfizer Inc., Collegeville, PA, USA; 5Health Economic and Outcomes Research Department, Pfizer Alcobendas, Madrid, Spain
Background: The purpose of this study was to assess the cost-effectiveness of bazedoxifene and raloxifene for prevention of vertebral and nonvertebral fractures among postmenopausal Spanish women aged 55–82 years with established osteoporosis and a high fracture risk.
Methods: A Markov model was developed to represent the transition of a cohort of postmenopausal osteoporotic women through different health states, ie, patients free of fractures, patients with vertebral or nonvertebral fractures, and patients recovered from a fracture. Efficacy data for bazedoxifene were obtained from the Osteoporosis Study. The perspective of the Spanish National Health Service was chosen with a time horizon of 27 years. Costs were reported in 2010 Euros. Deterministic results were presented as expected cost per quality-adjusted life-year (QALY), and probabilistic results were represented in cost-effectiveness planes.
Results: In deterministic analysis, the expected cost per patient was higher in the raloxifene cohort (€13,881) than in the bazedoxifene cohort (€13,436). QALYs gained were slightly higher in the bazedoxifene cohort (14.56 versus 14.54). Results from probabilistic sensitivity analysis showed that bazedoxifene has a slightly higher probability of being cost-effective for all threshold values independent of the maximum that the National Health Service is willing to pay per additional QALY.
Conclusion: Bazedoxifene was shown to be a cost-effective treatment option for the prevention of fractures in Spanish women with postmenopausal osteoporosis and a high fracture risk. When comparing bazedoxifene with raloxifene, it may be concluded that the former is the dominant strategy.
Keywords: osteoporosis, bazedoxifene, raloxifene, vertebral, nonvertebral, fracture, efficacy, costs
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]