12 to 2.97 between 2000 and see more 2007 and is expected to further decrease to 2.52 by the year 2025 [2]. With increasing life expectancies in men and higher excess mortality after hip fractures in men than in women [4], osteoporosis in men will become a large burden on learn more society and healthcare systems. Current treatments available for male osteoporosis, however, remain limited including alendronate, risedronate, zoledronate and parathormone [1]. Strontium ranelate has been primarily developed and approved for the treatment of postmenopausal osteoporosis. In clinical trials in postmenopausal women with osteoporosis,
strontium ranelate has been shown to be safe and effective in reducing the risk of vertebral and non-vertebral
fractures in a wide scatter of patients, from osteopenia to very elderly subjects, over a long period (up to 10 years) selleck compound [5–9]. The cost-effectiveness of strontium ranelate in postmenopausal women has also been demonstrated in different settings [10–14]. Recently, strontium ranelate also demonstrated to be effective for the treatment of male osteoporosis in a multicentre randomised controlled trial (i.e., the MALEO Trial) [15]. Under continuing economic pressure, the assessment of a new health intervention, however, goes beyond the three regulatory criteria of quality, safety and efficacy. The assessment of cost-effectiveness is considered as the fourth
hurdle to market, and plays an increasingly role in healthcare decision making [16]. Many countries have introduced formal requirements for economic analyses as part of the pricing or reimbursement decisions [17]. As the economic value of strontium ranelate in populations of men has not been analysed yet, this study aims to estimate the cost-effectiveness of strontium ranelate, compared with no treatment, for the treatment of Belgian men with Histone demethylase osteoporosis or a prevalent vertebral fracture (PVF). Materials and methods Economic model The simulation model is the same as the model developed for postmenopausal osteoporotic (PMO) women which has been validated [18] and used in many published health economic analyses [12, 13, 19–23]. Recently, an updated version of the model using a 6-month cycle length has been developed [23]. This last model version was slightly revised in this study to also include a health state for venous thromboembolic events (VTEs). The model was programmed using the software TreeAge Pro 2011 (TreeAge Pro Inc., Williamston, MA, USA). The Markov model health states are no fracture, death, VTE, hip fracture, clinical vertebral fracture, wrist fracture, other fracture and the corresponding post-fracture states. Post-fracture states were created as some parameters (e.g., fracture disutility) were estimated over a 1-year period [23].