The University of Southampton
University of Southampton Institutional Repository

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

Partial adherence: a new perspective on health economic assessment in osteoporosis
Partial adherence: a new perspective on health economic assessment in osteoporosis
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.
adherence, compliance, cost-effectiveness, persistence
0937-941X
2565-2573
Kanis, J.A.
8da04a36-08a7-4310-b4b4-a6d432439587
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Hiligsmann, M.
71dd82d4-b500-45d1-b0d6-3414459cf4c4
Rabenda, V.
031d104e-c09a-4802-9cc6-13112ca20e9c
Reginster, J.Y.
4083b457-5347-4ece-a53e-af19c8868c42
Rizzoli, R.
2214fb77-8fb7-4c0b-bfc4-9f8d3cace5d7
Kanis, J.A.
8da04a36-08a7-4310-b4b4-a6d432439587
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Hiligsmann, M.
71dd82d4-b500-45d1-b0d6-3414459cf4c4
Rabenda, V.
031d104e-c09a-4802-9cc6-13112ca20e9c
Reginster, J.Y.
4083b457-5347-4ece-a53e-af19c8868c42
Rizzoli, R.
2214fb77-8fb7-4c0b-bfc4-9f8d3cace5d7

Kanis, J.A., Cooper, C., Hiligsmann, M., Rabenda, V., Reginster, J.Y. and Rizzoli, R. (2011) Partial adherence: a new perspective on health economic assessment in osteoporosis. Osteoporosis International, 22 (10), 2565-2573. (doi:10.1007/s00198-011-1668-0). (PMID:21617992)

Record type: Article

Abstract

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.

Full text not available from this repository.

More information

e-pub ahead of print date: 27 May 2011
Published date: October 2011
Keywords: adherence, compliance, cost-effectiveness, persistence
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 201895
URI: http://eprints.soton.ac.uk/id/eprint/201895
ISSN: 0937-941X
PURE UUID: 2fb233b9-c43e-4598-ab7e-bc233dd4ef4a
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 01 Nov 2011 11:24
Last modified: 17 Dec 2019 01:56

Export record

Altmetrics

Contributors

Author: J.A. Kanis
Author: C. Cooper ORCID iD
Author: M. Hiligsmann
Author: V. Rabenda
Author: J.Y. Reginster
Author: R. Rizzoli

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×