ArticleBMC health services research2011
Cost of non-persistence with oral bisphosphonates in post-menopausal osteoporosis treatment in France.
Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Executive summary: Italian guidelines for diagnosis, risk stratification, and care continuity of fragility fractures 2021.Frontiers in endocrinology · 2023Pooled it
- A systematic review of models used in cost-effectiveness analyses of preventing osteoporotic fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Pooled it
- Improving High-Risk Osteoporosis Medication Adherence and Safety With an Automated Dashboard.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Cost-consequence analysis of continuous denosumab therapy for osteoporosis treatment in South Korea.BMC musculoskeletal disorders · 2024Article
- Cost-Utility of Acromegaly Pharmacological Treatments in a French Context.Frontiers in endocrinology · 2021Article
- Cost-effectiveness of gastro-resistant risedronate tablets for the treatment of postmenopausal women with osteoporosis in France.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
- Effect of improved medication adherence on health care costs in osteoporosis patients.Medicine · 2018Observational
- Anti-osteoporotic treatments in France: initiation, persistence and switches over 6 years of follow-up.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Association between gastrointestinal events and compliance with osteoporosis therapy.Bone reports · 2016Article
- Cost-utility of denosumab for the treatment of postmenopausal osteoporosis in Spain.ClinicoEconomics and outcomes research : CEOR · 2015Article
- Long-term persistence and switching patterns among women using osteoporosis therapies: 24- and 36-month results from POSSIBLE US™.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Observational
- Challenges in implementing and maintaining osteoporosis therapy.International journal of women's health · 2014Review
- Association between refill compliance to oral bisphosphonate treatment, incident fractures, and health care costs--an analysis using national health databases.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2013Article
- Bone care nurses and the evolution of the nurse's educational function: the Guardian Angel(®) research project.Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal DiseasesArticle
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring the last decade, oral bisphosphonates (BP) became the most widely prescribed pharmacologic class for post-menopausal osteoporosis. However, many surveys revealed the important issue of poor persistence with those drugs resulting in a failure of treatment to reduce fracture risk sufficiently. Using a published Markov model, this study analyses the economic impact of non-persistence with bisphosphonates in the context of the introduction of generics in France.
methodsDirect costs of vertebral, hip and wrist fracture were assessed and included in an existing 10-year Markov model developed to analyse consequences of non-persistence. Three alternatives of comparison were set: no treatment, real-world persistence, and ideal persistence. Simulated patients' characteristics matched those from a French observational study and the real-world adherence alternative employed persistence data from published database analysis. The risk of fracture of menopausal women and the risk reduction associated with the drugs were based on results reported in clinical trials. Incremental cost-effectiveness ratios (ICERs) were calculated first between real-world adherence and no treatment alternatives, and second between ideal and real-world persistence alternatives. The cost of non-persistence was defined as the difference between total cost of ideal and real-world persistence alternatives.
resultsWithin fractured women population, mean costs of 10-year management of fracture were significantly different between the three alternatives with €7,239 (± €4,783), €6,711 (± €4,410) and €6,134 (± €3,945) in the no-treatment, the real-world and ideal persistence alternatives, respectively (p < 0.0001). Cost-effectiveness ratio for real-world treatment persistence compared with no-treatment alternative was found dominant and as well, alternative of ideal persistence dominated the former. Each ten percentage point of persistence gain amounted to €58 per patient, and extrapolation resulted in a global annual cost of non-persistence of over €30 million to the French health care system, with a substantial transfer from hospital to pharmacy budgets.
conclusionWithin term, improving persistence with oral bisphosphonates should be economically dominant on levels currently known in real-world. Given this potential savings, ambitious adherence-enhancing interventions should be considered in osteoporotic patients.
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