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Osteoporosis International
Published in: Osteoporosis International 10/2011

01-10-2011 | Consensus Statement

Partial adherence: a new perspective on health economic assessment in osteoporosis

Authors: J. A. Kanis, C. Cooper, M. Hiligsmann, V. Rabenda, J-Y. Reginster, R. Rizzoli

Published in: Osteoporosis International | Issue 10/2011

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Abstract

Summary

Partial adherence in osteoporosis increases the risk for fragility fracture and has considerable impact on cost-effectiveness. This review highlights a number of avenues for further research, such as improved definition of thresholds of compliance and persistence, as well as gap length, offset times, and fraction of benefit.

Introduction

A number of economic models have been developed to evaluate osteoporosis therapies and support decisions regarding efficient allocation of health care resources. Adherence to treatment is seldom incorporated in these models, which may reduce their validity for decision-making since adherence is poor in real-world clinical practice.

Methods

An ad hoc working group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review key issues concerning the incorporation of partial adherence in health economic models.

Results

Observational data have shown that poor adherence is associated with an increase in the risk for fragility fracture. Health economic modelling indicates that full adherence is associated with more quality-adjusted life years gained than partial adherence, as well as higher treatment costs and lower fracture-related costs. Although adherence appears as an important driver of cost-effectiveness, the effect is dependent on a range of other variables, such as offset time, fraction of benefit, fracture risk, fracture efficacy, fracture-related costs, and drug cost, some of which are poorly defined. Current models used to evaluate cost-effectiveness in osteoporosis may oversimplify the contributions of compliance and persistence.

Conclusion

Partial adherence has a significant impact on cost-effectiveness. Further research is required to optimise thresholds of compliance and persistence, the impact of gap length, offset times, and fraction of benefit.
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Metadata
Title
Partial adherence: a new perspective on health economic assessment in osteoporosis
Authors
J. A. Kanis
C. Cooper
M. Hiligsmann
V. Rabenda
J-Y. Reginster
R. Rizzoli
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 10/2011
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-011-1668-0

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