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dc.contributor.authorChen, M
dc.contributor.authorSi, L
dc.contributor.authorWinzenberg, TM
dc.contributor.authorGu, J
dc.contributor.authorJiang, Q
dc.contributor.authorPalmer, AJ
dc.date.accessioned2020-12-21T04:30:36Z
dc.date.available2020-12-21T04:30:36Z
dc.date.issued2016
dc.identifierpii: ppa-10-415
dc.identifier.citationChen, M., Si, L., Winzenberg, T. M., Gu, J., Jiang, Q. & Palmer, A. J. (2016). Cost-effectiveness of raloxifene in the treatment of osteoporosis in Chinese postmenopausal women: impact of medication persistence and adherence.. Patient Prefer Adherence, 10, pp.415-423. https://doi.org/10.2147/PPA.S100175.
dc.identifier.issn1177-889X
dc.identifier.urihttp://hdl.handle.net/11343/257653
dc.description.abstractAIMS: Raloxifene treatment of osteoporotic fractures is clinically effective, but economic evidence in support of raloxifene reimbursement is lacking in the People's Republic of China. We aimed at evaluating the cost-effectiveness of raloxifene in the treatment of osteoporotic fractures using an osteoporosis health economic model. We also assessed the impact of medication persistence and adherence on clinical outcomes and cost-effectiveness of raloxifene. METHODS: We used a previously developed and validated osteoporosis state-transition microsimulation model to compare treatment with raloxifene with current practices of osteoporotic fracture treatment (conventional treatment) from the health care payer's perspective. A Monte Carlo probabilistic sensitivity analysis with microsimulations was conducted. The impact of medication persistence and adherence on clinical outcomes and the cost-effectiveness of raloxifene was addressed in sensitivity analyses. The simulated patients used in the model's initial state were 65-year-old postmenopausal Chinese women with osteoporosis (but without previous fractures), simulated using a 1-year cycle length until all patients had died. Costs were presented in 2015 US dollars (USD), and costs and effectiveness were discounted at 3% annually. The willingness-to-pay threshold was set at USD 20,000 per quality-adjusted life year (QALY) gained. RESULTS: Treatment with raloxifene improved clinical effectiveness by 0.006 QALY, with additional costs of USD 221 compared with conventional treatment. The incremental cost-effectiveness ratio was USD 36,891 per QALY gained. The cost-effectiveness decision did not change in most of the one-way sensitivity analyses. With full raloxifene persistence and adherence, average effectiveness improved compared with the real-world scenario, and the incremental cost-effectiveness ratio was USD 40,948 per QALY gained compared with conventional treatment. CONCLUSION: Given the willingness-to-pay threshold, raloxifene treatment was not cost-effective for treatment of osteoporotic fractures in postmenopausal Chinese women. Medication persistence and adherence had a great impact on clinical- and cost-effectiveness, and therefore should be incorporated in future pharmacoeconomic studies of osteoporosis interventions.
dc.languageeng
dc.publisherInforma UK Limited
dc.titleCost-effectiveness of raloxifene in the treatment of osteoporosis in Chinese postmenopausal women: impact of medication persistence and adherence.
dc.typeJournal Article
dc.identifier.doi10.2147/PPA.S100175
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titlePatient Preference and Adherence
melbourne.source.volume10
melbourne.source.pages415-423
dc.rights.licenseCC BY-NC
melbourne.elementsid1285943
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820231
melbourne.contributor.authorPalmer, Andrew
dc.identifier.eissn1177-889X
melbourne.accessrightsOpen Access


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