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New Bone Drug May Not be Worth Its High Price

Forteo costs 8 times as much as standard osteoporosis treatment, researchers note

TUESDAY, June 13, 2006 (HealthDay News) -- A new drug to treat osteoporosis is not cost effective compared to existing drugs -- and in fact, costs eight times as much, a new study finds.

Teriparatide, sold under the brand name Forteo, did not provide more cost-effective results than the already commonly prescribed alendronate, sold under the brand name Fosamax, concludes a U.S. government-funded study conducted by researchers at the Stanford University School of Medicine.

"We're not saying you shouldn't use this new drug at all, but, given that we have limited health-care resources, we need to consider whether we as a society are prepared to pay the additional cost of the drug, given the effectiveness of existing therapies," study author Dr. Hau Liu, postdoctoral fellow at Stanford's Center for Health Policy/Center for Primary Care and Outcomes Research, said in a prepared statement.

While alendronate has an average cost of about $900 per patient per year, teriparatide carries a price tag of around $6,700 per year, the researchers said.

Liu's research team used a computer-simulated model to study data on more than 200,000 hypothetical postmenopausal female patients, looking at whether teriparatide offered better results when compared with the much-cheaper alendronate. The women studied were white and had severe osteoporosis but had not previously undergone treatment for their osteoporosis.

The computer models ran through four treatment strategies -- vitamin D plus calcium supplementation only; alendronate for five years; teriparatide for two years; and teriparatide for two years followed by alendronate for five years.

Researchers evaluated the models based on treatment, fracture history, current fractures, death rates, admission to a nursing home, and adverse reactions to the treatment. They also compared cost-effectiveness to quality of life for each patient.

Treatment with alendronate alone proved cost-effective, at a rate of $11,600 per year adjusted for quality of life. Teriparatide treatment, however, did not rate as cost-effective or offer better benefits at a cost of $172,300 per quality-adjusted life-year.

Results of the study, which was funded by the Agency for Healthcare Research and Quality (AHRQ) and the Department of Veterans Affairs, are published in the June 12 issue of Archives of Internal Medicine.

The researchers did note that teriparatide may be appropriate for patients with severe osteoporosis, or those who did not respond well to alendronate.

"In recent years, we've seen several new drugs introduced that yield small benefits at a high price, but this isn't going to be a successful pricing strategy forever, as we're seeing more outcry over high drug prices," said senior study author Dr. Alan Garber, professor and director of the Stanford health policy center. "It's one more piece of information they'll want to keep in mind when deciding which treatment to prescribe."

More information

The American Academy of Family Physicians has more information on treating osteoporosis.

SOURCES: Stanford University Medical Center, news release, June 12, 2006
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