THE COST-EFFECTIVENESS OF IBANDRONATE AND ALENDRONATE FOR THE TREATMENT OF OSTEOPOROSIS IN A SPECIALIZED CLINIC IN TIRANA

Authors

  • Mirela MIRACI Faculty of Pharmacy, University of Medicine, Tirana, Albania
  • Arlinda Demeti Albanian Order of Pharmacists
  • Zamira Ylli University of Medicine
  • Suela KELLICI University of Medicine
  • Dhurata Tarifa Univerity Hospital Center ¨Mother Theresa

Keywords:

Biphosphonates, Osteoporosis, Alendronate, Tirana

Abstract

Objective: Biphosphonates are well known drugs for their efficacy in reducing fracture incidence, increasing bone density and improving bone micro architecture. The aim of this study is to evaluate the effectiveness of ibandronate and alendronate used in the treatment of osteoporosis in post-menopausal women over the age of 50 y at a specialized clinic in Tirana and to calculate the annual cost of osteoporosis treatment and perform a cost-effectiveness analysis.

Methods: Study design: Retrospective study The patients included were all female, in menopause or post-menopause with T-score-1 to-6, treated with alendronate or ibandronate. The effectiveness of the treatment was calculated as the average percentage of change in bone mineral density (av. % of change in BMD) between 2011 and 2010 (baseline). The annual cost of the osteoporosis treatment according to the protocols and the cost of the DXA (dual x-ray absorptiometry) scan were calculated and the comparison of cost-effectiveness was performed.

Results: Patients with osteoporosis treated with ibandronate (n=24) had a statistically significant higher average change from baseline compared to patients treated with alendronate (n=46) (Mann Whitney U = 66.0, p<0.01). The annual cost of treatment with ibandronate was 1.3 times higher than that of alendronate.

The cost/efficacy ratio was 13.434 units for ibandronate and 31.677 units for alendronate type A1.

Conclusion: Ibandronate is more effective and cost-effective than alendronate in the treatment of osteoporosis.


 

Downloads

Download data is not yet available.

References

Christiansen C. Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993;94:646–50.

Kanis JA, Johnell O. Requirements for DXA for the management of osteoporosis in europe. Osteoporosis Int 2005;16:229–38.

Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int 2006;17:1726–33.

Dorina R. Osteoporosis in Tirana. PhD thesis; 2011. Available from: URL: http://www.bksh.al/adlib/scripts/ wwwopac. exe?DATABASE=catalo&OPAC_URL=/adlib/beginner/index_al. html&LANGUAGE=1&%250=700000678&LIMIT=0). [Last accessed on 20 May]

British Orthopaedic Association. The care of patients with fragility fracture; 2007. p. 37-8.

Burge RT, Worley D, Johansen A. The cost of osteoporotic fractures in the UK: projections for 2000–2020. J Med Econ 2008;4:51–2.

Blume SW, Curtis JR. Medical costs of osteoporosis in the elderly medicare population. Osteoporos Int 2011;22:1835-44.

BMJ Group. Annual zoledronic acid for osteoporosis. Drug Ther Bull 2008;46:93-6.

Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761-7.

Srinivasa Rao Sirasanagandla, K Sreedhara Ranganath Pai, Kumar Mr Bhat. Preventive role of emblica offcinalis and cissus quadrangularis on bone loss in osteoporosis. Int J Pharm Pharm Sci 2013;5:465-70.

Anton Bahtiar, Aini Gusmira, Raymond Tjandrawinata. Functional analysis of 70% ethanolic extract of akar kelembak (Rheum Officinale Baill.) On 3t3 L1 preadipocyte cell lines in osteogenic medium. Int J Pharm Pharm Sci 2014;6:86-9.

Delmas PD. Treatment of postmenopausal osteoporosis. Lancet 2002;359:2018–26.

Hochberg MC, Ross PD, Black D. Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture intervention trial research group. Arthritis Rheum 1999;42;1246-54.

Hochberg MC, Greenspan S, Wasnich RD. Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocrinol Metab 2002;87:1586-92.

Epstein S. The roles of bone mineral density, bone turnover, and other properties in reducing fracture risk during antiresorptive therapy. Mayo Clin Proc 2005;80:379-88.

McClung MR, Wasnich RD, Recker R. Oral daily ibandronate prevents bone loss in early postmenopausal women with osteoporosis. J Bone Miner Res 2004;19:11-8.

Rosen CJ. Postmenopausal osteoporosis. N Engl J Med 2005;353:595-603.

Surendra G Gattani, Abasaheb B Patil, Sachin S Kushare. Pharmacoeconomics: a review. Asian J Pharm Clin Res 2009;2:15-24.

Miller PD, Epstein S, Sedarati F, Reginster JY. Once-monthly oral ibandronate compared with weekly oral alendronate in postmenopausal osteoporosis: results from the head-to-head MOTION study. Available from: URL: http://www.ncbi.nlm.nih.gov/pubmed/18042311. [Last accessed on 20 May]

MA Paggiosi, N Peel, E McCloskey, JS Walsh, R Eastell. Comparison of the effects of three oral bisphosphonate therapies on the peripheral skeleton in postmenopausal osteoporosis: the TRIO study. Osteoporosis Int 2014;25:2729-41.

Earnshaw SR, Beard SM, Lynch NO, Cooper A, Cowell W, Middelhoven HA. Comparison of the cost-effectiveness of bisphosphonates using persistence data from a UK propsective RCT. 28th Annual Meeting of the American Society for Bone and Mineral Research; 2006.

Published

01-10-2015

How to Cite

MIRACI, M., A. Demeti, Z. Ylli, S. KELLICI, and D. Tarifa. “THE COST-EFFECTIVENESS OF IBANDRONATE AND ALENDRONATE FOR THE TREATMENT OF OSTEOPOROSIS IN A SPECIALIZED CLINIC IN TIRANA”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 7, no. 11, Oct. 2015, pp. 207-11, https://journals.innovareacademics.in/index.php/ijpps/article/view/7596.

Issue

Section

Original Article(s)