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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

DOI https://doi.org/10.2147/CEOR.S42755

Checked for plagiarism Yes

Review by Single-blind

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

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