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Cost-effectiveness of dual-energy X-ray absorptiometry plus antiresorptive treatment in Australian women with breast cancer who receive aromatase inhibitors

Sowa, Marcin; Downes, Martin J.; Gordon, Louisa

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Postmenopausal women with breast cancer on aromatase inhibitor (AI) treatment are at increased risk of bone mineral density loss, which may lead to minimal trauma fractures. We examined the cost-effectiveness of dual energy X-ray absorptiometry (DXA) with antiresorptive (AR) therapy compared with fracture risk assessment, lifestyle advice, and vitamin supplementation. We used a hypothetical Markov cohort model of lifetime duration for 60-year-old women with early stage breast cancer receiving...[Show more]

dc.contributor.authorSowa, Marcin
dc.contributor.authorDownes, Martin J.
dc.contributor.authorGordon, Louisa
dc.date.accessioned2021-01-12T23:13:26Z
dc.identifier.issn0914-8779
dc.identifier.urihttp://hdl.handle.net/1885/219310
dc.description.abstractPostmenopausal women with breast cancer on aromatase inhibitor (AI) treatment are at increased risk of bone mineral density loss, which may lead to minimal trauma fractures. We examined the cost-effectiveness of dual energy X-ray absorptiometry (DXA) with antiresorptive (AR) therapy compared with fracture risk assessment, lifestyle advice, and vitamin supplementation. We used a hypothetical Markov cohort model of lifetime duration for 60-year-old women with early stage breast cancer receiving AIs. The data to inform the model came from medical literature, epidemiological reports, and costing data sets. Two eligibility scenarios for AR therapy were considered: (A) osteoporosis and (B) osteopenia or osteoporosis. The main outcomes were incremental cost per quality-adjusted life years gained and cumulative fractures per 1000 women, calculated relative to the comparator. Key aspects of the model were explored in sensitivity analyses. Due to relatively low effectiveness gains, the outcomes were primarily driven by the costs. The incremental cost per quality-adjusted life year gained was A$47,556 and A$253,000 for scenarios A and B, respectively. The numbers of fractures avoided were 56 and 77 per 1000 women, respectively. The results were most sensitive to the initial probability of osteoporosis, baseline risk of fracture, and cohort starting age. Compared with risk assessment and lifestyle advice only, a DXA scan followed by an AR treatment is potentially cost-effective for women aged 60 and over undergoing AI therapy for early breast cancer. However, the number of fractures averted through this intervention is small. 2016, The Japanese Society for Bone and Mineral Research and Springer Japan.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherSpringer Verlag
dc.rights© The Japanese Society for Bone and Mineral Research and Springer Japan 2016
dc.sourceJournal of Bone and Mineral Metabolism
dc.subjectDual-energy X-ray absorptiometry
dc.subjectAntiresorptive therapy
dc.subjectCost-effectiveness
dc.subjectMarkov model
dc.subjectAromatase inhibitors
dc.titleCost-effectiveness of dual-energy X-ray absorptiometry plus antiresorptive treatment in Australian women with breast cancer who receive aromatase inhibitors
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume35
dc.date.issued2017
local.identifier.absfor140208 - Health Economics
local.identifier.ariespublicationa383154xPUB12189
local.identifier.ariespublicationa383154xPUB12189
local.publisher.urlhttps://link.springer.com
local.type.statusPublished Version
local.contributor.affiliationSowa, Przemyslaw (Prem), College of Health and Medicine, ANU
local.contributor.affiliationDownes, Martin J., Griffith University
local.contributor.affiliationGordon, Louisa, Queensland Institute of Medical Research
local.description.embargo2099-12-31
local.bibliographicCitation.issue2
local.bibliographicCitation.startpage199
local.bibliographicCitation.lastpage208
local.identifier.doi10.1007/s00774-016-0742-2
local.identifier.absseo920207 - Health Policy Economic Outcomes
dc.date.updated2020-11-02T04:17:42Z
CollectionsANU Research Publications

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