N C Harvey1,2,3, E McCloskey4,5, J A Kanis6,7, J Compston8, C Cooper1,2,3. 1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 2. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK. 3. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. 4. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. 5. Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK. 6. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. w.j.pontefract@sheffield.ac.uk. 7. Institute for Health and Aging, Catholic University of Australia, Melbourne, Australia. w.j.pontefract@sheffield.ac.uk. 8. Cambridge Biomedical Campus, Cambridge, UK.
Abstract
PURPOSE: To comment on the latest technology appraisal of the National Institute for Clinical Excellence (NICE) in osteoporosis. METHODS: Review of NICE Technology Appraisal (TA464) on bisphosphonate use in osteoporosis. RESULTS: The NICE appraisal on bisphosphonate use in osteoporosis indicates that treatment with oral bisphosphonates may be instituted at a FRAX 10-year probability of major osteoporotic fracture above 1%. Implementation would mean that all women aged 50 years or older are deemed eligible for treatment, a position that would increase the burden of rare long-term side effects across the population. CONCLUSION: Cost-effectiveness thresholds for low-cost interventions should not be used to set intervention thresholds but rather to validate the implementation of clinically driven intervention thresholds.
PURPOSE: To comment on the latest technology appraisal of the National Institute for Clinical Excellence (NICE) in osteoporosis. METHODS: Review of NICE Technology Appraisal (TA464) on bisphosphonate use in osteoporosis. RESULTS: The NICE appraisal on bisphosphonate use in osteoporosis indicates that treatment with oral bisphosphonates may be instituted at a FRAX 10-year probability of major osteoporotic fracture above 1%. Implementation would mean that all women aged 50 years or older are deemed eligible for treatment, a position that would increase the burden of rare long-term side effects across the population. CONCLUSION: Cost-effectiveness thresholds for low-cost interventions should not be used to set intervention thresholds but rather to validate the implementation of clinically driven intervention thresholds.
Entities:
Keywords:
Cost-effectiveness; FRAX; Intervention thresholds; National Institute for Clinical Excellence; National Osteoporosis Guideline Group; Osteoporosis
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