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See detailHospitalisation costs of hip fractures in Belgium
Hiligsmann, Mickaël ULg; Gathon, Henry-Jean ULg; Bruyère, Olivier ULg et al

in Osteoporosis International (2011, March), 22(Suppl.1), 332

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See detailPatient out-of-pocket contributions related to hip fracture hospital costs in Belgium
Hiligsmann, Mickaël ULg; Gathon, Henry-Jean ULg; Bruyère, Olivier ULg et al

in Osteoporosis International (2011, March), 22(Suppl.1), 333

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See detailRisk of hip fracture in community-dwelling and institutionalized osteoporotic patients: a 3-year study
Bruyère, Olivier ULg; Hiligsmann, Mickaël ULg; Zegels, Brigitte ULg et al

in Osteoporosis International (2011, March), 22(Suppl.1), 332-333

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See detailIncidence of hip fracture in Belgium between 2000 and 2007 and future projections
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Detilleux, Johann ULg et al

in Osteoporosis International (2011, March), 22(Suppl.1), 145

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See detailThe clinical and economic burden of poor adherence with osteoporosis medications in Ireland
Hiligsmann, Mickaël ULg; McGowan, Bernie; Bennett, Kathleen et al

in Value in Health (2011), 14

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See detailPartial adherence: a new perspective on health economic assessment in osteoporosis.
Kanis, J. A.; Cooper, C.; Hiligsmann, Mickaël ULg et al

in Osteoporosis International (2011), 22(10), 2565-73

Partial adherence in osteoporosis increases the risk for fragility fracture and has considerable impact on cost-effectiveness. This review highlights a number of avenues for further research, such as ... [more ▼]

Partial adherence in osteoporosis increases the risk for fragility fracture and has considerable impact on cost-effectiveness. This review highlights a number of avenues for further research, such as improved definition of thresholds of compliance and persistence, as well as gap length, offset times, and fraction of benefit. INTRODUCTION: A number of economic models have been developed to evaluate osteoporosis therapies and support decisions regarding efficient allocation of health care resources. Adherence to treatment is seldom incorporated in these models, which may reduce their validity for decision-making since adherence is poor in real-world clinical practice. METHODS: An ad hoc working group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review key issues concerning the incorporation of partial adherence in health economic models. RESULTS: Observational data have shown that poor adherence is associated with an increase in the risk for fragility fracture. Health economic modelling indicates that full adherence is associated with more quality-adjusted life years gained than partial adherence, as well as higher treatment costs and lower fracture-related costs. Although adherence appears as an important driver of cost-effectiveness, the effect is dependent on a range of other variables, such as offset time, fraction of benefit, fracture risk, fracture efficacy, fracture-related costs, and drug cost, some of which are poorly defined. Current models used to evaluate cost-effectiveness in osteoporosis may oversimplify the contributions of compliance and persistence. CONCLUSION: Partial adherence has a significant impact on cost-effectiveness. Further research is required to optimise thresholds of compliance and persistence, the impact of gap length, offset times, and fraction of benefit. [less ▲]

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See detailA FRAX(R) model for the assessment of fracture probability in Belgium.
Johansson, H.; Kanis, J. A.; McCloskey, E. V. et al

in Osteoporosis International (2011), 22(2), 453-61

A country-specific FRAX(R) model was developed from the epidemiology of fracture and death in Belgium. Fracture probabilities were identified that corresponded to currently accepted reimbursement ... [more ▼]

A country-specific FRAX(R) model was developed from the epidemiology of fracture and death in Belgium. Fracture probabilities were identified that corresponded to currently accepted reimbursement thresholds. INTRODUCTION: The objective of this study was to evaluate a Belgian version of the WHO fracture risk assessment (FRAX(R)) tool to compute 10-year probabilities of osteoporotic fracture in men and women. A particular aim was to determine fracture probabilities that corresponded to the reimbursement policy for the management of osteoporosis in Belgium and the clinical scenarios that gave equivalent fracture probabilities. METHODS: Fracture probabilities were computed from published data on the fracture and death hazards in Belgium. Probabilities took account of age, sex, the presence of clinical risk factors and femoral neck bone mineral density (BMD). Fracture probabilities were determined that were equivalent to intervention (reimbursement) thresholds currently used in Belgium. RESULTS: Fracture probability increased with age, lower BMI, decreasing BMD T-score and all clinical risk factors used alone or combined. The 10-year probabilities of a major osteoporosis-related fracture that corresponded to current reimbursement guidelines ranged from approximately 7.5% at the age of 50 years to 26% at the age of 80 years where a prior fragility fracture was used as an intervention threshold. For women at the threshold of osteoporosis (femoral neck T-score = -2.5 SD), the respective probabilities ranged from 7.4% to 15%. Several combinations of risk-factor profiles were identified that gave similar or higher fracture probabilities than those currently accepted for reimbursement in Belgium. CONCLUSIONS: The FRAX(R) tool has been used to identify possible thresholds for therapeutic intervention in Belgium, based on equivalence of risk with current guidelines. The FRAX(R) model supports a shift from the current DXA-based intervention strategy, towards a strategy based on fracture probability of a major osteoporotic fracture that in turn may improve identification of patients at increased fracture risk. The approach will need to be supported by health economic analyses. [less ▲]

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See detailAnalyse coût-efficacité des traitements anti-osteoporotiques
Hiligsmann, Mickaël ULg

Scientific conference (2010, November)

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See detailTrend of hip fracture incidence in Belgium between 2000 and 2007 and future projections
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Detilleux, Johann ULg et al

in Value in Health (2010, November), 13(7), 303

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See detailStrontium ranelate: long-term efficacy against vertebral, nonvertebral and hip fractures in patients with postmenopausal osteoporosis
Reginster, Jean-Yves ULg; Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg

in Therapeutic Advances in Musculoskeletal Disease (2010), 2(3), 133-143

Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile, optimizing therapeutic adherence ... [more ▼]

Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile, optimizing therapeutic adherence. Strontium ranelate is the first compound to simultaneously decrease bone resorption and stimulate bone formation. Its antifracture efficacy, at various skeletal sites, has been established up to 8 years, through studies of the highest methodological standards. Increases in bone mineral density, observed after 1 year of treatment, are predictive of the long-term fracture efficacy, hence suggesting, for the first time in osteoporosis, that bone densitometry can be used as a monitoring tool for both efficacy and compliance. Owing to a positive benefit/risk ratio, strontium ranelate may now be considered as a first-line treatment in the management of osteoporosis [less ▲]

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See detailA FRAX® model for the assessment of fracture probability in Belgium
Neuprez, Audrey ULg; Johansson, H.; Kanis, J. et al

in Osteoporosis International (2010, May), 21(Suppl.1), 255

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