- Title
- Cost-effectiveness of bisphosphonates for prevention of fracture related to glucocorticoid-induced osteoporosis in Malaysia
- Creator
- Mohd-Tahir, Nurul-Ain; Thomas, Paraidathathu; Mohamed-Said, Mohd-Shahrir; Makmor-Bakry, Mohd; Li, Shu-Chen
- Relation
- International Journal of Rheumatic Diseases Vol. 21, Issue 3, p. 647-655
- Publisher Link
- http://dx.doi.org/10.1111/1756-185X.13206
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2018
- Description
- Introduction: Glucocorticoid therapy is associated with an appreciable risk of bone loss leading to fractures that require expensive treatments. This study aimed to evaluate the cost-effectiveness of bisphosphonates for prevention of hip fracture in glucocorticoid-induced osteoporosis (GIOP) in Malaysia. Method: Retrospective data were collected from GIOP patients referred to the Universiti Kebangsaan Malaysia Medical Centre. Fracture events and direct medical costs were compared between bisphosphonates and calcium/vitamin D combination. Results: Fracture events were reported in 28 out of 93 included patients, with hip and vertebral fractures representing 42.9% and 35.7%, respectively. Overall, the use of bisphosphonates could not be considered cost-effective for treatment of all GIOP patients. The presence of certain fracture risk factors was able to modify the cost-effectiveness of bisphosphonates. Bisphosphonates was considered cost-effective if started in patients more than 60 years old. However, the use of bisphosphonates was not cost-effective in GIOP patients with secondary osteoporosis. The incremental cost-effectiveness ratios (ICER) of bisphosphonates in patients with risk factors of previous fracture or rheumatoid arthritis were Malaysian Ringgits (MYR) 108 603.40 and MYR 25 699.21, respectively.Conclusion: Fracture risk factors of age, previous fracture, rheumatoid arthritis and secondary osteoporosis may modify the cost-effectiveness outcomes of bisphosphonates. Bisphosphonates would be considered cost-effective in patients more than 60 years old as compared to calcium/vitamin D treatments. Further evaluation of the impact of fracture risk factors in larger populations would provide more precise information to better assist rational and economical use of anti-osteoporosis treatment in GIOP patients.
- Subject
- bisphosphonates; cost-effectiveness analysis; fractures; glucocorticoid-induced osteoporosis; risk factors
- Identifier
- http://hdl.handle.net/1959.13/1447384
- Identifier
- uon:43137
- Identifier
- ISSN:1756-1841
- Language
- eng
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