New evaluation of osteoporosis therapies
EurekAlert Public release date: 15-May-2003 [ Print This Article | Close This Window ]
Contact: Susan Brooks susan.brooks@aventis.com 908-243-7564 Aventis
Paula Koenigs koenigs.pm@pg.com 513-622-3923 P&G Pharmaceuticals
New evaluation of osteoporosis therapies
Finds gastrointestinal-related cost differences San Diego, CA (May 15, 2003) -- In a new analysis, gastrointestinal (GI)-related medical expenses for osteoporosis patients initiating therapy with Fosamax® (alendronate sodium tablets) were nearly three times higher than for those patients initiating therapy with Actonel® (risedronate sodium tablets). The data were presented at the annual meeting of the American Association of Clinical Endocrinologists (AACE).
The evaluation assessed the medical costs to managed care organizations for outpatient visits (e.g., hospital outpatient and physician office visits), inpatient care (e.g., hospitalization) and prescriptions for gastro-protective agents, over the first four months of therapy. In this analysis, the average monthly cost for GI-related medical treatment was $2.52 per Actonel patient, compared to $7.40 per Fosamax daily patient and $7.50 per Fosamax weekly patient. Inpatient visits -- typically expensive components in overall medical care -- were 0.2 visits (per 100 patients per month) for Actonel, and 1.2 and 1.6 visits (per 100 patients per month) for Fosamax daily and Fosamax weekly, respectively.
"Extent of inpatient care was the main reason for the difference in GI-related medical costs," said Natalie Borisov, PhD, health economist at P&G Pharmaceuticals, who led the evaluation. "GI-related medical costs are a factor that managed care organizations take into consideration when evaluating the cost profile of an osteoporosis therapy."
Treating patients with a weekly dose of Fosamax versus a daily dose did not markedly change the level of GI-related medical expense or number of inpatient visits that these patients experienced.
Analysis Details The economic evaluation was conducted with a large medical and pharmaceutical claims database licensed from the health care consulting service, Protocare Sciences. The analysis included 3,947 subjects (93 percent women) age 65 years or older who initiated treatment with Actonel (5 mg/day) or Fosamax (5 mg/day, 10 mg/day, 35 mg/week or 70 mg/week) between November 2000 and August 2001.
Patients were separated into two groups: those with a "GI history" and those with "no GI history." The group with a "GI history" had a GI diagnosis (based on internationally standardized codes), had undergone a GI procedure, had taken medications for GI conditions, or had taken medications associated with increased risk of GI conditions, during a six-month pre-treatment period. The data discussed above were for those patients in the "no GI history" group. In the "GI history" group, Actonel patients also experienced lower GI-related medical costs than Fosamax patients. Costs were valued using 2002 US dollars. Causality between treatment and GI events was not assessed.
About Osteoporosis Osteoporosis is a skeletal disorder characterized by reduced bone strength predisposing a person to an increased risk of fracture. According to the National Osteoporosis Foundation, 1.2 million women suffer osteoporotic fractures in the U.S. each year. Risk factors for osteoporosis and subsequent fractures include loss of estrogen production, advanced age, preexisting fractures, and low bone mineral density. Studies show that among postmenopausal women with osteoporosis who experience a spinal fracture, one out of five will suffer their next spinal fracture within just one year, potentially leading to a fracture cascade.
Preventive measures, such as not smoking, maintaining a balanced diet supplemented with calcium and vitamin D, and engaging in weight-bearing exercise like walking, can reduce an individual's chances of developing osteoporosis. However, in some people these preventive measures may not be enough, and medications like Actonel may be beneficial.
About Actonel® (risedronate sodium tablets) Actonel is developed by Procter & Gamble Pharmaceuticals and co-marketed by Procter & Gamble Pharmaceuticals and Aventis. Actonel 35 mg Once-a-Week and Actonel 5 mg daily are indicated for the prevention and treatment of osteoporosis in postmenopausal women. Actonel 5 mg daily is also indicated for the prevention and treatment of glucocorticoid-induced osteoporosis (GIO) in men and women either initiating or continuing systemic glucocorticoid treatment (greater than or equal to 7.5 mg/d prednisone or equivalent) for chronic diseases.
In clinical trials, Actonel was generally well tolerated. Actonel is contraindicated in patients with hypocalcemia, known hypersensitivity to any component of this product, or inability to stand or sit upright for at least 30 minutes. Hypocalcemia and other disturbances of bone and mineral metabolism should be effectively treated before starting Actonel therapy. Actonel is not recommended for use in patients with severe renal impairment (creatinine clearance < 30 mL/min).
Bisphosphonates may cause upper gastrointestinal disorders such as dysphagia, esophagitis and esophageal or gastric ulcer. Patients should pay particular attention to the dosing instructions, as failure to take the drug according to instructions may compromise clinical benefits and may increase the risk of adverse events. In clinical trials, the overall incidence of adverse events with Actonel 5 mg daily was comparable to placebo. The most commonly reported adverse events regardless of causality were infection (primarily upper respiratory, placebo 29.7 percent vs. Actonel 5 mg 29.9 percent), back pain (23.6 percent vs. 26.1 percent), and arthralgia (21.1 percent vs. 23.7 percent).
In a one-year clinical trial comparing Actonel 35 mg Once-a-Week and Actonel 5 mg daily, the overall incidence of adverse events with the two dosing regimens was similar. The most commonly reported adverse events regardless of causality were infection (Actonel 35 mg 20.6 percent vs. Actonel 5 mg 19.0 percent), arthralgia (14.2 percent vs. 11.5 percent) and constipation (12.2 percent vs. 12.5 percent). Please visit www.actonel.com for full prescribing information for Actonel.
About The Alliance for Better Bone Health The Alliance for Better Bone Health was formed by Procter & Gamble and Aventis in May 1997 to promote bone health and disease awareness through numerous activities to support physicians and patients around the globe.
About Procter & Gamble Two billion times a day, P&G brands touch the lives of people around the world. Some of the nearly 300 P&G brands consumers know and use with confidence in over 160 countries around the world include: Pampers®, Tide®, Ariel®, Always®, Whisper®, Pantene®, Bounty®, Pringles®, Folgers®, Charmin®, Downy®, Lenor®, Iams®, Crest®, Olay®, and Clairol Nice 'n Easy®. Some of P&G Pharmaceuticals leading prescription products include Actonel® (risedronate sodium tablets), Asacol® (mesalamine), and Macrobid® (nitrofurantoin monohydrate macrocrystals). The P&G community consists of nearly 102,000 employees working in almost 80 countries worldwide. Please visit www.pg.com for the latest news and in-depth information about P&G and its brands.
About Aventis Aventis is dedicated to treating and preventing disease by discovering and developing innovative prescription drugs and human vaccines. In 2002, Aventis generated sales of € 17.6 billion (US $16.6 billion), invested € 3.1 billion (US $3 billion) in research and development and employed approximately 71,000 people in its core business. Aventis corporate headquarters are in Strasbourg, France. The company's prescription drugs business is conducted in the U.S. by Aventis Pharmaceuticals Inc., which is headquartered in Bridgewater, New Jersey. For more information about Aventis in the U.S., please visit: www.aventis-us.com.
Copies of this release are available on the Procter & Gamble Pharmaceuticals Web site at www.pgpharma.com, on the Aventis Pharmaceuticals U.S. Web site at www.aventis-us.com, or by calling 800-207-8049.
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