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Abstract Number: 1966

Cost-Effectiveness of Bazedoxifene Compared with Raloxifene in the Treatment of Postmenopausal Osteoporotic Women

Mickaël Hiligsmann1, Wafa Ben Sedrine1 and J.-Y. Reginster2, 1Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium, 2Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Economics, fractures and osteoporosis

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Session Information

Title: Osteoporosis and Metabolic Bone Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose: Bazedoxifene is a novel selective estrogen receptor modulator (SERM) in development for the prevention and treatment of osteoporosis. In addition to the therapeutic value of a new agent, evaluation of the cost-effectiveness compared with relevant alternative treatment(s) is an important consideration to facilitate health-care decision making. This study evaluated the cost-effectiveness of bazedoxifene compared with raloxifene for the treatment of postmenopausal women with osteoporosis.

Methods: The cost-effectiveness of treatment for 3-years with bazedoxifene was compared with raloxifene using an updated version of a previously validated Markov microsimulation model. Analyses were conducted from a healthcare payer perspective and, the base-case population was women (aged 70 years) with bone mineral density T-score ≤-2.5. The effects of bazedoxifene and raloxifene on fracture risk were derived from the 3-year results of a randomized, double-blind, placebo- and active-controlled study, including postmenopausal women with osteoporosis.

Results: The cost-effectiveness analysis based on efficacy data from the overall clinical trial indicated that bazedoxifene and raloxifene were equally cost-effective. When the results were examined based on the subgroup analysis of women at higher risk of fractures, bazedoxifene was dominant (lower cost for higher effectiveness) compared with raloxifene in most of the simulations. Sensitivity analyses confirmed the robustness of the results, which were largely independent of starting age of treatment, fracture risk, cost and disutility. In addition, when the cost of raloxifene was reduced by half, bazedoxifene remained cost-effective, at a threshold of €35,000 per quality-adjusted life-years gained, in 85% of the simulations.

Conclusion: Under the assumption of improved anti-fracture efficacy of bazedoxifene over raloxifene in women with high risk of fractures, this study suggests that bazedoxifene can be considered cost-effective, and even dominant, when compared with raloxifene in the treatment of postmenopausal osteoporotic women.


Disclosure:

M. Hiligsmann,

Amgen, Novartis, Pfizer, Servier, SMB,

2,

SMB, Servier,

5;

W. Ben Sedrine,
None;

J. Y. Reginster,

Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed, NPS, Theramex, UCB, Merck ,Sharp and Dohme, Rottapharm, IBSA, Genevrier, Teijin, Teva, Ebewee pharma, Zodiac, Analis, Novo Nordisk,

5,

Bristol Myers Squibb, Merck Sharp & Dohme, Pfizer, Rottapharm, Teva, Lilly, Novartis, Roche, GlaxoSmithKline, Amgen, Servier,

2.

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