THE USE OF REAL WORLD DATA TO BUILD ECONOMIC MODELS: A CASE STUDY OF OSTEOPOROSIS

Objectives The aim of this study is to analyze healthcare costs of osteoporosis and to build a economic model cost-effectiveness of pharmacological intervents based on real world data Methods The cost analysis was conducted taking each healthcare service into account during the study period (2005-2008). A hypothetical scenario based on the real-life available evidence was constructed. The mean level of adherence to populate the hypothetical scenario of full adherence was set at MPR >80%. The model was built by adding a step value to the real-world adherence of each subject so that the subject shifted to the hypotetical scenario of full adherence. Cost-effectiveness of full adherence compared to real-world adherence was expressed in terms of ICER and the number of fractures avoided was set as an effectiveness unit of measure. Results The mean annual healthcare cost was € 247.44 per not fractured patient and € 1,044.85 per fractured patient. The economic model showed that the average cost of medical treatments in case of optimal adherence per patient/year would increase from € 88.73 in real-world adherence to € 125.52 in full adherence. The rising costs are compensated by a reduction in number of fractures, decreasing by 65%. In this scenario, also the total yearly costs related hospitalizations would decrease from € 319,379 in real-word adherence to € 110,917 in full adherence. The ICER, expressed in terms of cost/fracture avoided equals € 821 (cost that the NHS should invest to avoide a fracture) Conclusions This study demonstrated the potential of the use of existing data sources to evaluate appropriateness of drug use. Drugs cost money to buy, but if we use them in an appropriate way we can also save costs in other areas. In particular enhancing adherence to medication may lead to reductions in the number of patients requiring hospitalization.