Cost-effectiveness of vitamin D and calcium supplementation in the treatment of postmenopausal women

in Osteoporosis International (2013, April), 24(Suppl.1), 198

Health Technology Assessment in Osteoporosis.

in Calcified Tissue International (2013)

We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of ... [more ▼]

We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent <euro>31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources. [less ▲]

Nominal group technique to select attributes for discrete choice experiments: an example for drug treatment choice in osteoporosis.

in Patient preference and adherence (2013), 7

BACKGROUND: Attribute selection represents an important step in the development of discrete-choice experiments (DCEs), but is often poorly reported. In some situations, the number of attributes identified ... [more ▼]

BACKGROUND: Attribute selection represents an important step in the development of discrete-choice experiments (DCEs), but is often poorly reported. In some situations, the number of attributes identified may exceed what one may find possible to pilot in a DCE. Hence, there is a need to gain insight into methods to select attributes in order to construct the final list of attributes. This study aims to test the feasibility of using the nominal group technique (NGT) to select attributes for DCEs. METHODS: Patient group discussions (4-8 participants) were convened to prioritize a list of 12 potentially important attributes for osteoporosis drug therapy. The NGT consisted of three steps: an individual ranking of the 12 attributes by importance from 1 to 12, a group discussion on each of the attributes, including a group review of the aggregate score of the initial rankings, and a second ranking task of the same attributes. RESULTS: Twenty-six osteoporotic patients participated in five NGT sessions. Most (80%) of the patients changed their ranking after the discussion. However, the average initial and final ranking did not differ markedly. In the final ranking, the most important medication attributes were effectiveness, side effects, and frequency and mode of administration. Some (15%) of the patients did not correctly rank from 1 to 12, and the order of attributes did play a role in the ranking. CONCLUSION: The NGT is feasible for selecting attributes for DCEs. Although in the context of this study, the NGT session had little impact on prioritizing attributes, this approach is rigorous, transparent, and improves the face validity of DCEs. Additional research in other contexts (different decisional problems or different diseases) is needed to determine the added value of the NGT session, to assess the optimal ranking/rating method with control of ordering effects, and to compare the attributes selected with the different approaches. [less ▲]

Comparison of the proportion of patients potentially treated with an anti-osteoporotic drug using the current criteria of the Belgian national social security and the new suggested FRAX criteria

in Rheumatology International (2012)

To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX or the current criteria were used to determine access to reimbursement. This is ... [more ▼]

To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX or the current criteria were used to determine access to reimbursement. This is a retrospective study based on data from 1,000 women randomly selected from an outpatient hospital specialized in bone metabolism in Belgium. Proportions of potentially refunded treatments between FRAX and current criteria were compared. Out of the 1,000 women files, 890 have sufficient information to assess FRAX . In Belgium, current criteria include a bone mineral density (BMD) T score below -2.5 at the lumbar spine, the femoral neck or the total hip and/or at least a prevalent vertebral fracture. Using these criteria, 167 women (18.8 %) would have access to reimbursement. Using the criteria based on the validated Belgian FRAX tool, only 116 women (13.0 %) would have access to reimbursement, meaning that access to reimbursement based on FRAX criteria would reduce by 30 % the anti-osteoporosis drug expenses covered by the national social security. Interestingly, only 65 women out of the 116 (56.0 %) selected with the FRAX criteria were also selected with the current criteria of the national social security. A substantial proportion of individuals that would potentially receive a reimbursement for their treatment using the FRAX criteria do not have access to any refund for their treatment with the current criteria. Since patients identified with the FRAX tool are those with the highest risk profile for future fractures, reappraisals of treatment reimbursement guidelines are expected in Belgium. [less ▲]

What are the most important medication attributes for patients with osteoporosis ? Results from a qualitative study

in Osteoporosis International (2012, March), 23(S2), 81-82

Cost-effectiveness of bazedoxifene compared with raloxifene in the treatment of postmenopausal osteoporotic women

in Osteoporosis International (2012, March), 23(Suppl. 2), 312-313

Incidence des fractures de hanche en fonction des médicaments prescrits contre l'ostéoporose

in Ortho-Rhumato (2012), 10(4), 3

Un monde médical et économique en pleine évolution : maladies complexes et intérêt de l’évaluation économique des technologies de santé

in Revue Médicale de Liège (2012), 67(5-6), 258-262

The importance of integrating medication adherence into pharmacoeconomic analyses: the example of osteoporosis.

in Expert Reviews of Pharmacoeconomics & Outcomes Research (2012), 12(2), 159-66

Adherence to medications is poor and suboptimal in many chronic diseases. Nonadherence can reduce treatment effectiveness and can have an impact on healthcare costs. As a consequence, it may alter the ... [more ▼]

Adherence to medications is poor and suboptimal in many chronic diseases. Nonadherence can reduce treatment effectiveness and can have an impact on healthcare costs. As a consequence, it may alter the cost-effectiveness of drug therapies. This article emphasizes the importance of integrating medication compliance and persistence into pharmacoeconomic evaluations, using osteoporosis as an example. A limited number of studies carried out to date have suggested important economic implications of poor adherence to osteoporosis medications. Therefore, compliance and persistence should be an integral part of clinical studies and pharmacoeconomic analyses in order to estimate the cost-effectiveness of drug therapies in current community practice. Measuring adherence and incorporating it into health economic modeling may, however, pose particular challenges. [less ▲]

Evolution récente de l'incidence des fractures de hanche et de la consommation de médicaments anti-ostéoporotiques en Belgique

in Revue du Rhumatisme (2011, December), 78(Suppl. 5), 43-44