A Merck representative visits your office and tells you that Fosamax (alendronat

Question

A Merck representative visits your office and tells you that Fosamax (alendronate) will decrease the incidence of repeat hip fracture by 50% over 3 years. That excites you because you have 20 elderly women and 5 elderly men who already have fractured one hip in your practice. You locate the study by Black in Lancet (1996) and find out that fracture occurs in 2.2% of placebo patients and 1.1% of patients on Fosamax.

QUESTION: The daily cost for Fosamax is $3.65. Calculate the COPE for this brand name drug if the number of years treated is 3 years. Round to the nearest whole dollar.

QUESTION: The daily cost for generic alendronate is $0.21. Calculate the COPE for this generic name drug if the number of years treated is 3 years. Round to the nearest whole dollar.

Explanation / Answer

The fracture occurs in 2.2% of placebo patients and 1.1% of fosamax.

Reduction in bad outcome is from 2.2% to 1.1%,

Hence Absolute risk reduction, ARR = 2.2 -1.1 = 1.1%

Out of 100 patients 1.1 patient prevented bad outcome

NNT or number needed to treat one event is

NNT = 100/ARR = 100/1.1 = 90.909 =91 patients

Cost of preventing event, COPE = NNT x number of years x 365 days x daily cost of the pill

1. In the first case, daily cost for Fosamax is $3.65 used for 3 years

Hence COPE= 91 x 3 x 365x 3.65 = $ 363704.25 = $363704

2.In the second case, cost for generic alendronate is $0.21 used for 3 years

COPE = 91 x 3 x 365 x 0.21 = $ 20925.45 = $20926

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.