Skip to main content
Top
Published in: Osteoporosis International 1/2005

01-01-2005 | Original Article

Cost-effectiveness of raloxifene in the UK: an economic evaluation based on the MORE study

Authors: J. A. Kanis, F. Borgström, O. Johnell, A. Oden, D. Sykes, B. Jönsson

Published in: Osteoporosis International | Issue 1/2005

Login to get access

Abstract

Raloxifene treatment has been shown to reduce the risk of vertebral fractures and breast cancer in postmenopausal women. The long-term economic implications of treatment with raloxifene have not yet been investigated. The aim of this study was to assess the cost-effectiveness of treating postmenopausal women in the UK with raloxifene. A previously developed computer simulation model was used to estimate the cost-effectiveness of osteoporotic treatments with extra skeletal benefits. The model was populated with epidemiological data and cost data relevant for a UK female population. Data on the effect of treatment were taken from the Multiple Outcomes of Raloxifene (MORE) study, which recruited women with low bone mineral density or with a prior vertebral fracture. Cost-effectiveness was estimated using Quality Adjusted Life Years (QALYs) and life years gained as primary outcome measures. The cost per QALY gained of treating postmenopausal women without prior vertebral fractures was £18,000, £23,000, £18,000 and £21,000 at 50, 60, 70 and 80 years of age. Corresponding estimates for women with prior vertebral fractures were £10,000, £24,000, £18,000 and £20,000. In relation to threshold values that are recommended in the UK, the analysis suggests that raloxifene is cost-effective in the treatment of postmenopausal women at an increased risk of vertebral fractures.
Literature
1.
go back to reference Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645CrossRefPubMed Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645CrossRefPubMed
2.
go back to reference Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, Norton L, Nickelsen T, Bjarnason NH, Morrow M, Lippman ME, Black D, Glusman JE, Costa A, Jordan VC (1999) The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA 281:2189–2197CrossRefPubMed Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, Norton L, Nickelsen T, Bjarnason NH, Morrow M, Lippman ME, Black D, Glusman JE, Costa A, Jordan VC (1999) The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA 281:2189–2197CrossRefPubMed
3.
go back to reference Barrett-Connor E, Grady D, Sashegyi A, Anderson PW, Cox DA, Hoszowski K, Rautaharju P, Harper KD (2002) Raloxifene and cardiovascular events in osteoporotic postmenopausal women: four-year results from the MORE (Multiple Outcomes of Raloxifene Evaluation) randomized trial. JAMA 287:847–857CrossRefPubMed Barrett-Connor E, Grady D, Sashegyi A, Anderson PW, Cox DA, Hoszowski K, Rautaharju P, Harper KD (2002) Raloxifene and cardiovascular events in osteoporotic postmenopausal women: four-year results from the MORE (Multiple Outcomes of Raloxifene Evaluation) randomized trial. JAMA 287:847–857CrossRefPubMed
4.
go back to reference Raftery J (2001) NICE: faster access to modern treatments? Analysis of guidance on health technologies. BMJ 323:1300–1303CrossRefPubMed Raftery J (2001) NICE: faster access to modern treatments? Analysis of guidance on health technologies. BMJ 323:1300–1303CrossRefPubMed
5.
go back to reference Johannesson M, Hedbrant J and Jonsson B (1991) A computer simulation model for cost-effectiveness analysis of cardiovascular disease prevention. Med Inform (Lond) 16:355–362 Johannesson M, Hedbrant J and Jonsson B (1991) A computer simulation model for cost-effectiveness analysis of cardiovascular disease prevention. Med Inform (Lond) 16:355–362
6.
go back to reference Zethraeus N, Johannesson M, Jonsson B (1999) A computer model to analyze the cost-effectiveness of hormone replacement therapy. Int J Technol Assess Health Care 15:352–365PubMed Zethraeus N, Johannesson M, Jonsson B (1999) A computer model to analyze the cost-effectiveness of hormone replacement therapy. Int J Technol Assess Health Care 15:352–365PubMed
7.
go back to reference Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001) Cost-effectiveness of preventing hip fracture in the general female population. Osteoporos Int 12:356–361CrossRefPubMed Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001) Cost-effectiveness of preventing hip fracture in the general female population. Osteoporos Int 12:356–361CrossRefPubMed
8.
go back to reference Kanis JA, Johnell O, Oden A, De Laet C, Jonsson B, Dawson A (2002) Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30:251–258CrossRefPubMed Kanis JA, Johnell O, Oden A, De Laet C, Jonsson B, Dawson A (2002) Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30:251–258CrossRefPubMed
9.
go back to reference Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jonsson B (2002) Intervention thresholds for osteoporosis. Bone 31:26–31CrossRefPubMed Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jonsson B (2002) Intervention thresholds for osteoporosis. Bone 31:26–31CrossRefPubMed
10.
go back to reference Kanis JA, Johnell O, Oden A, Jonsson B, Dawson A, Dere W (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11:120–127PubMed Kanis JA, Johnell O, Oden A, Jonsson B, Dawson A, Dere W (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11:120–127PubMed
11.
go back to reference Zethraeus N, Ben Sedrine W, Caulin F, Corcaud S, Gathon HJ, Haim M, Johnell O, Jonsson B, Kanis JA, Tsouderos Y, Reginster JY (2002) Models for assessing the cost-effectiveness of the treatment and prevention of osteoporosis. Osteoporos Int 13:841–857CrossRefPubMed Zethraeus N, Ben Sedrine W, Caulin F, Corcaud S, Gathon HJ, Haim M, Johnell O, Jonsson B, Kanis JA, Tsouderos Y, Reginster JY (2002) Models for assessing the cost-effectiveness of the treatment and prevention of osteoporosis. Osteoporos Int 13:841–857CrossRefPubMed
12.
go back to reference Cauley JA, Norton L, Lippman ME, Eckert S, Krueger KA, Purdie DW, Farrerons J, Karasik A, Mellstrom D, Ng KW, Stepan JJ, Powles TJ, Morrow M, Costa A, Silfen SL, Walls EL, Schmitt H, Muchmore DB, Jordan VC, Ste-Marie LG (2001) Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial. Multiple outcomes of raloxifene evaluation. Breast Cancer Res Treat 65:125–134CrossRefPubMed Cauley JA, Norton L, Lippman ME, Eckert S, Krueger KA, Purdie DW, Farrerons J, Karasik A, Mellstrom D, Ng KW, Stepan JJ, Powles TJ, Morrow M, Costa A, Silfen SL, Walls EL, Schmitt H, Muchmore DB, Jordan VC, Ste-Marie LG (2001) Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial. Multiple outcomes of raloxifene evaluation. Breast Cancer Res Treat 65:125–134CrossRefPubMed
13.
go back to reference Delmas PD, Ensrud KE, Adachi JD, Harper KD, Sarkar S, Gennari C, Reginster JY, Pols HA, Recker RR, Harris ST, Wu W, Genant HK, Black DM, Eastell R (2002) Efficacy of raloxifene on vertebral fracture risk reduction in postmenopausal women with osteoporosis: four-year results from a randomized clinical trial. J Clin Endocrinol Metab 87:3609–3617CrossRefPubMed Delmas PD, Ensrud KE, Adachi JD, Harper KD, Sarkar S, Gennari C, Reginster JY, Pols HA, Recker RR, Harris ST, Wu W, Genant HK, Black DM, Eastell R (2002) Efficacy of raloxifene on vertebral fracture risk reduction in postmenopausal women with osteoporosis: four-year results from a randomized clinical trial. J Clin Endocrinol Metab 87:3609–3617CrossRefPubMed
14.
go back to reference Lothgren M, Zethraeus N (2000) Definition, interpretation and calculation of cost-effectiveness acceptability curves. Health Econ 9:623–630CrossRefPubMed Lothgren M, Zethraeus N (2000) Definition, interpretation and calculation of cost-effectiveness acceptability curves. Health Econ 9:623–630CrossRefPubMed
15.
go back to reference Neele SJ, Evertz R, De Valk-De Roo G, Roos JC, Netelenbos JC (2002) Effect of 1 year of discontinuation of raloxifene or estrogen therapy on bone mineral density after 5 years of treatment in healthy postmenopausal women. Bone 30:599–603CrossRefPubMed Neele SJ, Evertz R, De Valk-De Roo G, Roos JC, Netelenbos JC (2002) Effect of 1 year of discontinuation of raloxifene or estrogen therapy on bone mineral density after 5 years of treatment in healthy postmenopausal women. Bone 30:599–603CrossRefPubMed
16.
go back to reference Michaelsson K, Baron JA, Farahmand BY, Johnell O, Magnusson C, Persson PG, Persson I, Ljunghall S (1998) Hormone replacement therapy and risk of hip fracture: population based case-control study. The Swedish Hip Fracture Study Group. BMJ 316:1858–1863PubMed Michaelsson K, Baron JA, Farahmand BY, Johnell O, Magnusson C, Persson PG, Persson I, Ljunghall S (1998) Hormone replacement therapy and risk of hip fracture: population based case-control study. The Swedish Hip Fracture Study Group. BMJ 316:1858–1863PubMed
17.
go back to reference Felson DT, Zhang Y, Hannan MT, Kiel DP, Wilson PW, Anderson JJ (1993) The effect of postmenopausal estrogen therapy on bone density in elderly women. N Engl J Med 329:1141–1146CrossRefPubMed Felson DT, Zhang Y, Hannan MT, Kiel DP, Wilson PW, Anderson JJ (1993) The effect of postmenopausal estrogen therapy on bone density in elderly women. N Engl J Med 329:1141–1146CrossRefPubMed
18.
go back to reference Stevenson JC, Kanis JA, Christiansen C (1992) Bone-density measurement. Lancet 339:370–371CrossRef Stevenson JC, Kanis JA, Christiansen C (1992) Bone-density measurement. Lancet 339:370–371CrossRef
19.
go back to reference Million Women Study Collaborators (2003) Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet 362:419–427CrossRefPubMed Million Women Study Collaborators (2003) Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet 362:419–427CrossRefPubMed
20.
go back to reference Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674CrossRefPubMed Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674CrossRefPubMed
21.
go back to reference Felsenberg D, Silman A, Lunt M, Ambrecht G, Ismail A (2002) Incidence of Vertebral Fracture in Europe: results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 17:716–724PubMed Felsenberg D, Silman A, Lunt M, Ambrecht G, Ismail A (2002) Incidence of Vertebral Fracture in Europe: results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 17:716–724PubMed
22.
go back to reference Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed
23.
go back to reference Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMed Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMed
24.
go back to reference Cancer Statistics Registrations—Registrations of cancer diagnosed in 1998, England. Office for National Statistics: London, 2002 Cancer Statistics Registrations—Registrations of cancer diagnosed in 1998, England. Office for National Statistics: London, 2002
25.
go back to reference Cauley JA, Lucas FL, Kuller LH, Vogt MT, Browner WS, Cummings SR (1996) Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group. JAMA 276:1404–1408CrossRefPubMed Cauley JA, Lucas FL, Kuller LH, Vogt MT, Browner WS, Cummings SR (1996) Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group. JAMA 276:1404–1408CrossRefPubMed
26.
go back to reference Zhang Y, Kiel DP, Kreger BE, Cupples LA, Ellison RC, Dorgan JF, Schatzkin A, Levy D, Felson DT (1997) Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 336:611–617CrossRefPubMed Zhang Y, Kiel DP, Kreger BE, Cupples LA, Ellison RC, Dorgan JF, Schatzkin A, Levy D, Felson DT (1997) Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 336:611–617CrossRefPubMed
27.
go back to reference Kannel W, Wolf P, Garrison R (1987) The Framingham study: an epidemiological investigation of cardiovascular disease. US Department of Commerce National Technical Information Service, Springfield Kannel W, Wolf P, Garrison R (1987) The Framingham study: an epidemiological investigation of cardiovascular disease. US Department of Commerce National Technical Information Service, Springfield
28.
go back to reference Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM and Melton LJ 3rd (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Int Med 158:585–593CrossRef Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM and Melton LJ 3rd (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Int Med 158:585–593CrossRef
29.
go back to reference Technology Appraisals Series No. 5: Guidance for Manufacturers and Sponsors (2001) National Institute for Clinical Excellence Technology Appraisals Series No. 5: Guidance for Manufacturers and Sponsors (2001) National Institute for Clinical Excellence
30.
go back to reference Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8:611–617CrossRefPubMed Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8:611–617CrossRefPubMed
31.
go back to reference Kanis J, Brazier J, Stevenson M, Calvert W, Jones ML (2002) Treatment of established osteoporosis: a systematic review and cost-utility analysis. Health Technology Assessment 6:1–146 Kanis J, Brazier J, Stevenson M, Calvert W, Jones ML (2002) Treatment of established osteoporosis: a systematic review and cost-utility analysis. Health Technology Assessment 6:1–146
32.
go back to reference De Laet CE, van Hout BA, Burger H, Weel AE, Hofman A, Pols HA (1999) Incremental cost of medical care after hip fracture and first vertebral fracture: the Rotterdam study. Osteoporos Int 10:66–72CrossRefPubMed De Laet CE, van Hout BA, Burger H, Weel AE, Hofman A, Pols HA (1999) Incremental cost of medical care after hip fracture and first vertebral fracture: the Rotterdam study. Osteoporos Int 10:66–72CrossRefPubMed
33.
go back to reference Hutton J, Brown R, Borowitz M, Abrams K, Rothman M, Shakespeare A (1996) A new decision model for cost-utility comparisons of chemotherapy in recurrent metastatic breast cancer. Pharmacoeconomics 9 Suppl 2:8–22 Hutton J, Brown R, Borowitz M, Abrams K, Rothman M, Shakespeare A (1996) A new decision model for cost-utility comparisons of chemotherapy in recurrent metastatic breast cancer. Pharmacoeconomics 9 Suppl 2:8–22
34.
go back to reference Sanderson C, Kubin M (2001) Prevention of coronary heart disease through treatment of infection with Chlamydia pneumoniae? Estimation of possible effectiveness and costs. Health Care Manag Sci 4:269–279CrossRefPubMed Sanderson C, Kubin M (2001) Prevention of coronary heart disease through treatment of infection with Chlamydia pneumoniae? Estimation of possible effectiveness and costs. Health Care Manag Sci 4:269–279CrossRefPubMed
35.
go back to reference Daly E, Vessey MP, Barlow D, Gray A, McPherson K, Roche M (1996) Hormone replacement therapy in a risk-benefit perspective. Maturitas 23:247–259CrossRefPubMed Daly E, Vessey MP, Barlow D, Gray A, McPherson K, Roche M (1996) Hormone replacement therapy in a risk-benefit perspective. Maturitas 23:247–259CrossRefPubMed
36.
go back to reference Netten A, Rees T, Harrison G (2001) Unit costs of health and Social Care. Personal Social Services Research Unit, University of Kent. www.ukc.ac.uk/PSSRU/ Netten A, Rees T, Harrison G (2001) Unit costs of health and Social Care. Personal Social Services Research Unit, University of Kent. www.ukc.ac.uk/PSSRU/
37.
go back to reference Zethraeus N, Borgström F, Johnell I, Kanis JA, Jönsson B (2002) Costs and quality of life associated with osteoporosis related fractures—results from a Swedish survey. Working Paper Series in Economics and Finance, 512 Zethraeus N, Borgström F, Johnell I, Kanis JA, Jönsson B (2002) Costs and quality of life associated with osteoporosis related fractures—results from a Swedish survey. Working Paper Series in Economics and Finance, 512
38.
go back to reference Lundberg L (1999) Health-related quality of life in Sweden. Faculty of Pharmacy, Uppsala University Lundberg L (1999) Health-related quality of life in Sweden. Faculty of Pharmacy, Uppsala University
39.
go back to reference Kanis J, Johnell O, Oden A, Borgström F, Zethraeus N, Laet CD, Jönsson B (2004) The risk and burden of vertebral fracture in Sweden. Osteoporosis Int 15:20–26CrossRef Kanis J, Johnell O, Oden A, Borgström F, Zethraeus N, Laet CD, Jönsson B (2004) The risk and burden of vertebral fracture in Sweden. Osteoporosis Int 15:20–26CrossRef
40.
go back to reference Kind P, Dolan P, Gudex C, Williams A (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 316:736–741PubMed Kind P, Dolan P, Gudex C, Williams A (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 316:736–741PubMed
41.
go back to reference Johnell O, Jonsson B, Jonsson L, Black D (2003) Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314PubMed Johnell O, Jonsson B, Jonsson L, Black D (2003) Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314PubMed
42.
go back to reference Iglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Q J Med 95:305–311CrossRef Iglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Q J Med 95:305–311CrossRef
43.
go back to reference Johannesson M (1995) The cost effectiveness of hypertension treatment in Sweden. Pharmacoeconomics 7:242–250PubMed Johannesson M (1995) The cost effectiveness of hypertension treatment in Sweden. Pharmacoeconomics 7:242–250PubMed
44.
go back to reference Interim Life Tables (2002) Government Actuary’s Department Interim Life Tables (2002) Government Actuary’s Department
45.
go back to reference Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561CrossRefPubMed Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561CrossRefPubMed
46.
go back to reference Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882CrossRefPubMed Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882CrossRefPubMed
47.
go back to reference Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed
48.
go back to reference Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, Laet CD, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42CrossRefPubMed Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, Laet CD, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42CrossRefPubMed
49.
go back to reference Heit JA, Mohr DN, Silverstein MD, Petterson TM, O’Fallon WM, Melton LJ 3rd (2000) Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Int Med 160:761–768CrossRef Heit JA, Mohr DN, Silverstein MD, Petterson TM, O’Fallon WM, Melton LJ 3rd (2000) Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Int Med 160:761–768CrossRef
50.
go back to reference Kearon C (2003) Natural history of venous thromboembolism. Circulation 107:122–130CrossRef Kearon C (2003) Natural history of venous thromboembolism. Circulation 107:122–130CrossRef
51.
go back to reference Frost ML, Blake GM, Fogelman I (2001) Quantitative ultrasound and bone mineral density are equally strongly associated with risk factors for osteoporosis. J Bone Miner Res 16:406–416PubMed Frost ML, Blake GM, Fogelman I (2001) Quantitative ultrasound and bone mineral density are equally strongly associated with risk factors for osteoporosis. J Bone Miner Res 16:406–416PubMed
52.
go back to reference Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590CrossRefPubMed Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590CrossRefPubMed
53.
go back to reference Kanis J, Johnell O, Black D, Downs R, Sarkar S, Feurst T, Secrest R, Pavo I (2003) Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women defined by total hip bone mineral density. Bone 33:293–300CrossRefPubMed Kanis J, Johnell O, Black D, Downs R, Sarkar S, Feurst T, Secrest R, Pavo I (2003) Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women defined by total hip bone mineral density. Bone 33:293–300CrossRefPubMed
54.
go back to reference Stock JL, Bell NH, Chesnut CH 3rd, Ensrud KE, Genant HK, Harris ST, McClung MR, Singer FR, Yood RA, Pryor-Tillotson S, Wei L, Santora AC 2nd (1997) Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am J Med 103:291–297CrossRefPubMed Stock JL, Bell NH, Chesnut CH 3rd, Ensrud KE, Genant HK, Harris ST, McClung MR, Singer FR, Yood RA, Pryor-Tillotson S, Wei L, Santora AC 2nd (1997) Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am J Med 103:291–297CrossRefPubMed
55.
go back to reference Tonino RP, Meunier PJ, Emkey R, Rodriguez-Portales JA, Menkes CJ, Wasnich RD, Bone HG, Santora AC, Wu M, Desai R, Ross PD (2000) Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. Phase III Osteoporosis Treatment Study Group. J Clin Endocrinol Metab 85:3109–3115CrossRefPubMed Tonino RP, Meunier PJ, Emkey R, Rodriguez-Portales JA, Menkes CJ, Wasnich RD, Bone HG, Santora AC, Wu M, Desai R, Ross PD (2000) Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. Phase III Osteoporosis Treatment Study Group. J Clin Endocrinol Metab 85:3109–3115CrossRefPubMed
56.
go back to reference Bagger YZ, Tanko LB, Alexandersen P, Hansen HB, Mollgaard A, Ravn P, Qvist P, Kanis JA, Christiansen C (2004) Two to three years of hormone replacement treatment in healthy women have long-term prevention effects on bone mass and osteoporotic fractures: the PERF study. Bone 34:728–735CrossRefPubMed Bagger YZ, Tanko LB, Alexandersen P, Hansen HB, Mollgaard A, Ravn P, Qvist P, Kanis JA, Christiansen C (2004) Two to three years of hormone replacement treatment in healthy women have long-term prevention effects on bone mass and osteoporotic fractures: the PERF study. Bone 34:728–735CrossRefPubMed
57.
go back to reference Jalava T, Sarna S, Pylkkanen L, Mawer B, Kanis JA, Selby P, Davies M, Adams J, Francis RM, Robinson J, McCloskey EV (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1260PubMed Jalava T, Sarna S, Pylkkanen L, Mawer B, Kanis JA, Selby P, Davies M, Adams J, Francis RM, Robinson J, McCloskey EV (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1260PubMed
58.
go back to reference National Osteoporosis Foundation (1998) Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effective analysis. Osteoporos Int 8 (Suppl 4):1–88CrossRef National Osteoporosis Foundation (1998) Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effective analysis. Osteoporos Int 8 (Suppl 4):1–88CrossRef
59.
go back to reference Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13:768–776CrossRefPubMed Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13:768–776CrossRefPubMed
60.
go back to reference Inglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Q J Med 95:305–311CrossRef Inglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Q J Med 95:305–311CrossRef
61.
go back to reference Kanis JA, Borgstrom F, Johnell O, Jonsson B (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int (in press) Kanis JA, Borgstrom F, Johnell O, Jonsson B (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int (in press)
62.
go back to reference Borgstrom F, Johnell O, Kanis JA, Oden A, Sykes D, Jonsson B (2004) Cost-effectiveness of raloxifene in Sweden. An economic evaluation based on the MORE study. Pharmacoeconomics (in press) Borgstrom F, Johnell O, Kanis JA, Oden A, Sykes D, Jonsson B (2004) Cost-effectiveness of raloxifene in Sweden. An economic evaluation based on the MORE study. Pharmacoeconomics (in press)
Metadata
Title
Cost-effectiveness of raloxifene in the UK: an economic evaluation based on the MORE study
Authors
J. A. Kanis
F. Borgström
O. Johnell
A. Oden
D. Sykes
B. Jönsson
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 1/2005
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-004-1688-0

Other articles of this Issue 1/2005

Osteoporosis International 1/2005 Go to the issue