%0 Journal Article
%T Cost-effectiveness of enhancing adherence with oral bisphosphonates treatment in osteoporotic women: an empirical approach based on healthcare utilisation databases
%A Andrea Arf¨¨
%A Antonella Zambon
%A Giovanni Corrao
%A Lorenza Scotti
%A Luca Merlino
%J -
%D 2015
%R 10.1136/bmjopen-2013-003758
%X Objective Adherence with bisphosphonates therapy is generally low. Enhancing adherence with bisphosphonates would be effective in achieving the full benefits of therapy albeit a growth in the expenditure for supporting incremented drug use is expected. The cost-effectiveness of enhancing adherence with oral bisphosphonates in a large population of osteoporotic women has been assessed in the current study.

Design Retrospective cohort study.

Setting Healthcare utilisation databases of Lombardy Region, Italy.

Participants A cohort of 28£¿558 women aged 45£¿years or more, resident in the Italian Region of Lombardy, who were newly treated with oral bisphosphonates during 2003¨C2004, was followed for 6£¿years after index prescription.

Outcome measures Fracture-free survival time, healthcare cost and incremental cost-effectiveness ratio (ICER) of enhancing adherence, that is, the additional cost that would be spent every year for gaining one fracture-free year as a consequence of enhancing adherence at a certain level.

Results Enhanced adherence from 33% (baseline) to 80%, increased both fracture-free survivals from 970 to 973£¿years and healthcare costs from ?118£¿000 to ?265£¿000 every 1000 woman-years, with ICER value of ?53£¿000 (95% CI ?49£¿000 to ?58£¿000). ICER values were lower for older women (?50£¿000; 95% CI ?42£¿000 to ?58£¿000) and for those suffering from at least a chronic comorbidity (?25000; 95% CI 95% CI ?7000 to ?47£¿000).

Conclusions Enhancing adherence with oral bisphosphonates offers important benefits in reducing the risk of fracture, although at a substantial cost
%U https://bmjopen.bmj.com/content/4/3/e003758