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Alendronate is the only proven cost-effective medication for initiation of primary or secondary prevention of osteoporosis, according to draft assessments issued March 5 by the agency that determines which drugs the National Health Service uses in England and Wales.
If affirmed later this year, the National Institute for Health and Clinical Effectiveness (NICE) draft document would rule out the use of strontium ranelate, etidronate, risedronate, and raloxifene for primary prevention of osteoporosis in women with at least one clinical risk factor.
For initiation of secondary prevention, a separate NICE document would rule out those four drugs and teriparatide.
NICE found that nonproprietary alendronate, the second-cheapest drug, was as effective as risedronate, etidronate, strontium, and raloxifene. As a result, NICE's drafts ruled that alendronate was the most cost-effective medication. Only etidronate, at £85.65 ($171) a year, could match alendronate on price. However, the committee questioned the evidence regarding etidronate's effectiveness.
At an annual cost of £95.03 ($190) for once-weekly treatment, generic alendronate for primary prevention in patients at high risk of osteoporosis was estimated to cost £17,632 ($35,288) or less per quality-adjusted life year, a measurement of a single year in perfect health, compared with no treatment, according to the NICE committee that appraised the medications.
For initiation of secondary prevention among women with bone mineral density more than 2.5 standard deviations below normal confirmed by bone-density scanning, it was estimated to cost less than £27,422 ($54,881) per quality-adjusted life year, depending on age and treatment strategy, the committee said.
A NICE document on secondary prevention of osteoporosis issued in January 2005 recommended the use of all three bisphosphonates, raloxifene, and teriparatide for secondary prevention in postmenopausal women who have already had an osteoporosis-related fracture.
Alendronate is the only proven cost-effective medication for initiation of primary or secondary prevention of osteoporosis, according to draft assessments issued March 5 by the agency that determines which drugs the National Health Service uses in England and Wales.
If affirmed later this year, the National Institute for Health and Clinical Effectiveness (NICE) draft document would rule out the use of strontium ranelate, etidronate, risedronate, and raloxifene for primary prevention of osteoporosis in women with at least one clinical risk factor.
For initiation of secondary prevention, a separate NICE document would rule out those four drugs and teriparatide.
NICE found that nonproprietary alendronate, the second-cheapest drug, was as effective as risedronate, etidronate, strontium, and raloxifene. As a result, NICE's drafts ruled that alendronate was the most cost-effective medication. Only etidronate, at £85.65 ($171) a year, could match alendronate on price. However, the committee questioned the evidence regarding etidronate's effectiveness.
At an annual cost of £95.03 ($190) for once-weekly treatment, generic alendronate for primary prevention in patients at high risk of osteoporosis was estimated to cost £17,632 ($35,288) or less per quality-adjusted life year, a measurement of a single year in perfect health, compared with no treatment, according to the NICE committee that appraised the medications.
For initiation of secondary prevention among women with bone mineral density more than 2.5 standard deviations below normal confirmed by bone-density scanning, it was estimated to cost less than £27,422 ($54,881) per quality-adjusted life year, depending on age and treatment strategy, the committee said.
A NICE document on secondary prevention of osteoporosis issued in January 2005 recommended the use of all three bisphosphonates, raloxifene, and teriparatide for secondary prevention in postmenopausal women who have already had an osteoporosis-related fracture.
Alendronate is the only proven cost-effective medication for initiation of primary or secondary prevention of osteoporosis, according to draft assessments issued March 5 by the agency that determines which drugs the National Health Service uses in England and Wales.
If affirmed later this year, the National Institute for Health and Clinical Effectiveness (NICE) draft document would rule out the use of strontium ranelate, etidronate, risedronate, and raloxifene for primary prevention of osteoporosis in women with at least one clinical risk factor.
For initiation of secondary prevention, a separate NICE document would rule out those four drugs and teriparatide.
NICE found that nonproprietary alendronate, the second-cheapest drug, was as effective as risedronate, etidronate, strontium, and raloxifene. As a result, NICE's drafts ruled that alendronate was the most cost-effective medication. Only etidronate, at £85.65 ($171) a year, could match alendronate on price. However, the committee questioned the evidence regarding etidronate's effectiveness.
At an annual cost of £95.03 ($190) for once-weekly treatment, generic alendronate for primary prevention in patients at high risk of osteoporosis was estimated to cost £17,632 ($35,288) or less per quality-adjusted life year, a measurement of a single year in perfect health, compared with no treatment, according to the NICE committee that appraised the medications.
For initiation of secondary prevention among women with bone mineral density more than 2.5 standard deviations below normal confirmed by bone-density scanning, it was estimated to cost less than £27,422 ($54,881) per quality-adjusted life year, depending on age and treatment strategy, the committee said.
A NICE document on secondary prevention of osteoporosis issued in January 2005 recommended the use of all three bisphosphonates, raloxifene, and teriparatide for secondary prevention in postmenopausal women who have already had an osteoporosis-related fracture.