W.M. Hart, Carlos Rubio Terrés, A. Burrell, I. Arístegui Ruiz, Fernando Escobar Jiménez
Se realizó un análisis coste-efectividad del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato semanal, utilizándose un modelo de Markov y costes españoles. La reducción del riesgo de sufrir fractura de cadera fue, en pacientes con o sin fractura vertebral previa, del 60% y 40% con risedronato y del 51% y 21% con alendronato. La reducción del riesgo de fractura vertebral fue, en pacientes con fractura vertebral previa del 45% y del 55% con risedronato y alendronato respectivamente. El coste por fractura de cadera evitada (en mujeres tratadas a partir de los 70 años, con o sin fractura vertebral previa, y después de 10 años de tratamiento) osciló con risedronato entre 54.134 y 84.287 euros; con alendronato los costes fueron mayores: 67.853 y 173.748 euros. El coste por año de vida ajustado por calidad (AVAC) fue, así mismo, menor con risedronato (43.601-61.064 euros) que con alendronato (49.483-88.634) en pacientes con o sin fractura vertebral previa. Risedronato es más coste-efectivo que alendronato de administración semanal.
A cost-effectiveness analysis of the treatment of post-menopausal osteoporosis with risedronate and once-a-week alendronate was performed, using a Markov model and Spanish costs. The risk of hip fracture, in patients with or without previous vertebral fracture, was reduced by 60% and 40% with risedronate and 51% and 21% with alendronate, respectivelly. The reduction in the risk of vertebral fracture in patients with previous vertebral fracture was 45% and 55%, with risedronate and alendronate. The cost per hip fracture avoided (after onset of treatment in women aged 70 years, with or without vertebral fracture, and after 10 years of treatment) was 54,134 and 84,287 euros, respectively with risedronate. With alendronate the cost per hip fracture avoided was greater: 67,853 and 173,748 euros, respectively. The cost per quality adjusted life-year (QALY) was also lower with risedronate (43,601-61,064 euros) than with alendronate (49,483-88,634 euros) in patients with or without previous vertebral fracture, respectively. Risedronate is more cost-effective than once-a-week alendronate.