INTRODUCTION: Several osteoporosis therapies are now available. Given these therapy choices, a cost model considering the costs and consequences of treatment can be a useful tool for managed care organizations (MCO) to make optimal formulary decisions. METHODS: A one year budget impact was estimated on a MCO among patients aged 45 and older initiating osteoporosis drug therapy. Drug therapies included nasal calcitonin (CAL), risedronate (RIS), and alendronate (ALN). Total costs included drug wholesale acquisition costs (WAC), direct medical care costs for non-vertebral fractures, and gastro-intestinal (GI) side-effect costs from osteoporosis therapies. Medical care costs for each treatment group were calculated by multiplying therapy-specific non-vertebral fracture incidence rates by the direct medical care costs of fractures. Estimates for non-vertebral fracture incidence rates, GI side-effect costs, and medical care costs associated with non-vertebral fractures were obtained from Protocare Sciences® integrated administrative medical and pharmacy claims database. RESULTS: Each treatment group was comprised of approximately 93% women. The most expensive treatment group was CAL (annual cost was $1,268 per patient), which had both the highest drug acquisition costs ($865 per patient) and fracture-related medical costs ($403 per patient). The RIS group had the lowest total cost ($905 per patient), and was predicted to generate substantial cost savings compared to both CAL (saving of $374 per patient annually) and ALN (savings of $275 per patient annually). The majority of cost savings were due to lower medical costs related to the lower incidence of non-vertebral fractures. CONCLUSIONS: These results suggest that a MCO may achieve substantial cost savings when treating patients aged 45 and older with risedronate, versus nasal calcitonin and alendronate, due to lower drug acquisition costs, and fewer GI side-effects and non-vertebral fractures in the first year of therapy.
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Faculty Member's Name: Natalie N. Borisov, PhD
Other Financial or Material Support: P&GP Employee
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