Reference : Potential Clinical and Economic Impact of Nonadherence with Osteoporosis Medications.
Scientific journals : Article
Business & economic sciences : Special economic topics (health, labor, transportation…)
Human health sciences : Rheumatology
http://hdl.handle.net/2268/40948
Potential Clinical and Economic Impact of Nonadherence with Osteoporosis Medications.
English
Hiligsmann, Mickaël mailto [Université de Liège - ULg > HEC-Ecole de gestion de l'ULg : UER > Economie industrielle >]
Rabenda, Véronique mailto [Université de Liège - ULg > Département des sciences de la santé publique > Epidémiologie et santé publique >]
Gathon, Henry-Jean mailto [Université de Liège - ULg > HEC-Ecole de gestion de l'ULg : UER > Economie générale et gestion publique >]
Ethgen, Olivier mailto [Université de Liège - ULg > Département des sciences de la santé publique > Santé publique : aspects spécifiques >]
Reginster, Jean-Yves mailto [Université de Liège - ULg > Département des sciences de la santé publique > Epidémiologie et santé publique >]
2010
Calcified Tissue International
Springer Verlag
86
202-210
Yes (verified by ORBi)
International
0171-967X
New York
NY
[en] adherence ; burden ; compliance ; cost-effectiveness ; osteoporosis ; persistence
[en] This study aims to estimate the potential clinical and economic implications of therapeutic adherence to bisphosphonate therapy. A validated Markov microsimulation model was used to estimate the impact of varying adherence to bisphosphonate therapy on outcomes (the number of fractures and the quality-adjusted life-years [QALYs]), health-care costs, and the cost-effectiveness of therapy compared with no treatment. Adherence was divided into persistence and compliance, and multiple scenarios were considered for both concepts. Analyses were performed for women aged 65 years with a bone mineral density T-score of -2.5. Health outcomes and the cost-effectiveness of therapy improved significantly with increasing compliance and/or persistence. In the case of real-world persistence and with a medical possession ratio (MPR; i.e., the number of doses taken divided by the number of doses prescribed) of 100%, the QALY gain and the number of fractures prevented represented only 48 and 42% of the values estimated assuming full persistence, respectively. These proportions fell to 27 and 23% with an MPR value of 80%. The costs per QALY gained, for branded bisphosphonates (and generic alendronate), were estimated at <euro>19,069 (<euro>4,871), <euro>32,278 (<euro>11,985), and <euro>64,052 (<euro>30,181) for MPR values of 100, 80, and 60%, respectively, assuming real-world persistence. These values were <euro>16,997 (<euro>2,215), <euro>24,401 (<euro>6,179), and <euro>51,750 (<euro>20,569), respectively, assuming full persistence. In conclusion, poor compliance and failure to persist with osteoporosis medications results not only in deteriorating health outcomes, but also in a decreased cost-effectiveness of drug therapy. Adherence therefore remains an important challenge for health-care professionals treating osteoporosis.
Researchers ; Professionals
http://hdl.handle.net/2268/40948
10.1007/s00223-009-9329-4

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