Alendronate and Hormone Replacement Therapy in the Prevention of Osteoporotic Fracture: A Pharmacoeconomic Analysis Employing a Net-Benefit Regression Method of Cost-Effectiveness
Abstract
Osteoporosis is a common chronic condition which poses a substantial clinical, economic, and health-related quality-of-life (HRQOL) burden to the individual, the U.S. health care system, and society in general. The overall objective of this study was to evaluate the economic, clinical and humanistic outcomes of current osteoporosis interventions employed in the prevention of osteoporotic fractures in the Department of Defense (DoD) population. The overall objective encompassed four primary objectives: to assess the epidemiology of osteoporotic fracture in women > age 50; to determine the effectiveness of current osteoporosis interventions; to identify significant risk factors and other covariates in the prediction of osteoporotic fracture; and to determine the cost- effectiveness of current osteoporosis interventions. A three-year sample-based retrospective cohort study was conducted using DoD health care and prescription claims from fiscal years 2000 to 2003. Using an intent-to-treat study design, a total of 49,851 women > age 50 were followed for osteoporotic fracture. The effectiveness of the interventions was determined by performing a series of both logistic and direct Cox proportional hazard regressions. The net-benefit regression method of cost-effectiveness was employed to determine the cost-effectiveness of the treatment interventions and to determine the importance of covariates on the marginal cost-effectiveness of an intervention, while statistically controlling for the presence of risk factors and other covariates. The epidemiologic study results showed that the three-year cumulative incidence of an osteoporotic fracture was 2.5 % for the cohort (0.4% in patients without a diagnosis of osteoporosis; 6.1% in patients with a diagnosis of osteoporosis).
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2004
- Accession Number
- ADA425640
Entities
People
- Kevin W. Tiller
Organizations
- University of Texas at Austin