Annual cost of the drugs used in the treatment of osteoporosis after a review of the reference pricesCARTA AL DIRECTOR ( PDF ) Rev Osteoporos Metab Miner 2012 4;1:43-44
Díaz González JM, Groba Marco M, Sosa Henríquez M
Universidad de Las Palmas de Gran Canaria - Grupo de Investigación en Osteoporosis y Metabolismo Mineral - Las Palmas de Gran Canaria
In a review of the role of zoledronic acid in the treatment of osteoporosis published in a monograph of the Review of Osteoporosis and Mineral Metabolism  we included a table in which we presented the annual cost of the different drugs approved in Spain for the treatment of postmenopausal osteoporosis.
Subsequently, on the 30th December 2011, a resolution was published in the BOE due to which the reference prices of medicines were reviewed , modifying downwards the prices of all drugs.
For this reason, we have reviewed and updated the aforementioned table, including generic ibandronate, which was not available at the time of publication (Table1).
The prices are shown with or without VAT, depending on whether they apply to the Spanish peninsular or to the Canary Islands, where VAT is not applied. The Canary Islands indirect tax “Impuesto General Indirecto Canario” (IGIC) is not applied to pharmaceutical drugs, which means that the final price is net of VAT. Pharmaceutical drugs, which are packaged as 28 pills, are calculated at 13 packets per year, since it needs to be taken into account that pills in packets of 28 provide 28 x 12 months = 336 pills each year, with 29 more pills (1 packet) required. In drugs which are presented as weekly pills it is necessary to make the same correction (4 weeks x 12 months = 48 weeks, the year being 52 weeks), which also means that an additional packet needs to be added to correct the calculation of the annual cost. The same happens with nasal calcitonin. The exceptions, in the case of drugs administered orally, are monthly ibandronate and risedronate, whose calculation, due to their monthly administration, is made over 12 months. In the case of denosumab, its weekly administration is subcutaneous and comes with a preloaded syringe and needle. Finally, in the case of zoledronic acid it is necessary to add the price of the 5 ml vial, the cost of 1 syringe, needle and 100 ml of saline solution, plus the cost of the staff at the day hospital or place where it is administered, which varies from one hospital to another.
1. Sosa Henríquez M, Groba Marco M, Díaz González JM. El ácido zoledrónico en el tratamiento de la osteoporosis. Rev Osteoporos Metab Miner 2010;2 (Supl 4): 21-30.
2. Ministerio de Sanidad y Consumo. Resolución de 28 de diciembre de 2011, de la Dirección General de Farmacia y Productos Sanitarios, por la que se determinan los nuevos conjuntos de medicamentos de ámbito hospitalario y sus precios de referencia. Boletín Oficial del Estado. Viernes 30 de diciembre de 2011 Sec. I. Pág. 146119. Disponible en: http://www. boe.es/boe/dias/2011/12/30/pdfs/BOE-A-2011-20545.pdf. Consultado el 25 de marzo de 2012.