title: Using economics to prioritize research: a case study of randomized trials for the prevention of hip fractures due to osteoporosis.
abstract: OBJECTIVE
  To assess the role of economics, in combination with clinical judgement, for setting research priorities, using osteoporosis prevention (and, as a result, hip fracture prevention) as an example.
  
  
  METHODS
  Modelling the cost and effectiveness of each of six potential interventions to prevent hip fractures over the 5-year length of a randomized trial (vitamin D injection; thiazide diuretics; hormone replacement therapy; oral calcium and vitamin D; calcium alone; calcitonin). Drug costs were derived from the Monthly Index of Medical Specialties (MIMS); averted fracture costs and estimates of effectiveness were derived from published sources.
  
  
  RESULTS
  Vitamin D injection proved to be the most potentially cost-effective treatment with a cost-effectiveness ratio of 584 Pounds. If averted costs are included, this leads to a saving of 9,176,496 Pounds per 100,000 women treated. By contrast, the most expensive therapy was calcitonin (marginal cost-effectiveness ratio of 433,548 Pounds). This suggests that priority should be given to trials assessing the effectiveness of vitamin D injections.
  
  
  CONCLUSIONS
  Relatively simple economic modelling exercises can inform research priorities and could help optimize the use of scarce research resources.
authors: National Primary Care Research and Development Centre, Centre for Health Economics, University of York, UK.
authors: D
authors: D
authors: Torgerson
authors: C
authors: C
authors: Donaldson
authors: D
authors: D
authors: Reid
mesh_terms: D001581:Benzothiadiazines; D002116:Calcitonin / Q000191:economics / Q000627:therapeutic use; D002118:Calcium / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004232:Diuretics; D015914:Estrogen Replacement Therapy / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006292:Health Priorities; D006302:Health Services Research / Q000191:economics*; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D017059:Models, Econometric; D010024:Osteoporosis / Q000150:complications* / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D012109:Research Support as Topic / Q000191:economics*; D049993:Sodium Chloride Symporter Inhibitors / Q000191:economics / Q000627:therapeutic use; D006113:United Kingdom; D014807:Vitamin D / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use
chemical_list: D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D014807:Vitamin D; D002116:Calcitonin; D002118:Calcium