論文

査読有り
2013年2月

Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan

Journal of Bone and Mineral Research
  • Kensuke Moriwaki
  • ,
  • Hirotaka Komaba
  • ,
  • Shinichi Noto
  • ,
  • Shinichiro Yanagisawa
  • ,
  • Toru Takiguchi
  • ,
  • Hiroki Inoue
  • ,
  • Takeshi Toujo
  • ,
  • Masafumi Fukagawa
  • ,
  • Hideaki E. Takahashi

28
2
開始ページ
395
終了ページ
403
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/jbmr.1755
出版者・発行元
Wiley

Many postmenopausal women have osteopenia, a condition characterized by loss of bone mineral density (BMD) that is not as severe as in osteoporosis. The objective of this study was to estimate the cost-effectiveness of alendronate to prevent fractures in osteopenic postmenopausal women without a history of fracture in Japan. An individual simulation model was developed to predict lifetime costs and quality-adjusted life years (QALYs) of 5 years of preventive alendronate therapy versus no preventive therapy. The risk of hip and vertebral fracture associated with age and BMD was derived from epidemiologic studies in Japan. We ran the model with different combinations of age (65, 70, and 75 years), BMD (70%, 75%, and 80% of young adult mean [YAM]), and additional clinical risk factors. For 70-year-old women with a BMD of 70% of the YAM having one of the following risk factors: a family history of hip fracture, high alcohol intake, or current smoking, the incremental cost-effectiveness ratio (ICER) of alendronate was $92,937, $126,251, and $129,067 per QALY, respectively. These results were sensitive to age, BMD, and number of clinical risk factors. Probabilistic sensitivity analysis for the base case showed that in the presence of one, two, and three risk factors, alendronate was cost-effective in 0.2% to 2.6%, 13.1% to 56.1%, and 99.1% of the simulations, respectively, if society is willing to pay $50,000 per QALY. Additional analysis indicated that alendronate can be a good value in osteopenic women if the 10-year probability for a osteoporotic hip or vertebral fracture is more than 26.2%. Our results indicate that whether to treat osteopenia with alendronate should be determined on the basis of age, BMD, and number of clinical risk factors in terms of cost-effectiveness. © 2013 American Society for Bone and Mineral Research.

リンク情報
DOI
https://doi.org/10.1002/jbmr.1755
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22991163

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