OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of multi-therapy treatment strategies in the prevention of vertebral fractures in postmenopausal women with osteoporosis. DESIGN: A retrospective, incremental cost-effectiveness analysis was conducted from a societal perspective. It compared 9 treatment strategies over 3 years and incorporated the willingness of patients to initiate and continue each therapy. MAIN OUTCOME MEASURES AND RESULTS: Four nondominated strategies formed the efficient frontier in the following order: (i) calcium-->no therapy; (ii) ovarian hormone therapy (OHT)-->calcium-->no therapy [166 Canadian dollars ($Can)]; (iii) OHT-->etidronate-->calcium-->no therapy ($Can2331); and (iv) OHT-->alendronate-->calcium-->no therapy ($Can40,965). The figures in parentheses are the incremental costs per vertebral fracture averted to move to that strategy from the previous strategy for patients who had undergone a hysterectomy. CONCLUSIONS: We identified 4 efficient multi-therapy strategies for the treatment of vertebral osteoporosis in postmenopausal women, 2 of which were consistent with the practice guidelines of the Osteoporosis Society of Canada. Decision-makers may select from among these efficient strategies on the basis of incremental cost effectiveness.
OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of multi-therapy treatment strategies in the prevention of vertebral fractures in postmenopausal women with osteoporosis. DESIGN: A retrospective, incremental cost-effectiveness analysis was conducted from a societal perspective. It compared 9 treatment strategies over 3 years and incorporated the willingness of patients to initiate and continue each therapy. MAIN OUTCOME MEASURES AND RESULTS: Four nondominated strategies formed the efficient frontier in the following order: (i) calcium-->no therapy; (ii) ovarian hormone therapy (OHT)-->calcium-->no therapy [166 Canadian dollars ($Can)]; (iii) OHT-->etidronate-->calcium-->no therapy ($Can2331); and (iv) OHT-->alendronate-->calcium-->no therapy ($Can40,965). The figures in parentheses are the incremental costs per vertebral fracture averted to move to that strategy from the previous strategy for patients who had undergone a hysterectomy. CONCLUSIONS: We identified 4 efficient multi-therapy strategies for the treatment of vertebral osteoporosis in postmenopausal women, 2 of which were consistent with the practice guidelines of the Osteoporosis Society of Canada. Decision-makers may select from among these efficient strategies on the basis of incremental cost effectiveness.
Authors: D Grady; S M Rubin; D B Petitti; C S Fox; D Black; B Ettinger; V L Ernster; S R Cummings Journal: Ann Intern Med Date: 1992-12-15 Impact factor: 25.391
Authors: B L Riggs; S F Hodgson; W M O'Fallon; E Y Chao; H W Wahner; J M Muhs; S L Cedel; L J Melton Journal: N Engl J Med Date: 1990-03-22 Impact factor: 91.245
Authors: U A Liberman; S R Weiss; J Bröll; H W Minne; H Quan; N H Bell; J Rodriguez-Portales; R W Downs; J Dequeker; M Favus Journal: N Engl J Med Date: 1995-11-30 Impact factor: 91.245
Authors: E G Lufkin; H W Wahner; W M O'Fallon; S F Hodgson; M A Kotowicz; A W Lane; H L Judd; R H Caplan; B L Riggs Journal: Ann Intern Med Date: 1992-07-01 Impact factor: 25.391
Authors: S T Harris; N B Watts; R D Jackson; H K Genant; R D Wasnich; P Ross; P D Miller; A A Licata; C H Chesnut Journal: Am J Med Date: 1993-12 Impact factor: 4.965
Authors: John T Schousboe; Kristine E Ensrud; John A Nyman; Robert L Kane; L Joseph Melton Journal: Osteoporos Int Date: 2005-08-31 Impact factor: 4.507
Authors: Derek A Haaland; Dana R Cohen; Courtney C Kennedy; Nader A Khalidi; Jonathan D Adachi; Alexandra Papaioannou Journal: BMC Geriatr Date: 2009-07-14 Impact factor: 3.921