Cost effectiveness of multi-therapy treatment strategies in the prevention of vertebral fractures in postmenopausal women with osteoporosis.
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.


METHODS
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.


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.
Rosner
A J
AJ
Innovus Research Inc., Burlington, Ontario, Canada. arosner@innovus.com
Grima
D T
DT
Torrance
G W
GW
Bradley
C
C
Adachi
J D
JD
Sebaldt
R J
RJ
Willison
D J
DJ
D000368:Aged; D019386:Alendronate / Q000191:economics* / Q000627:therapeutic use; D002118:Calcium / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000191:economics / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy / Q000191:economics*; D004967:Estrogens / Q000191:economics / Q000627:therapeutic use; D012968:Etidronic Acid / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000191:economics*; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000191:economics* / Q000209:etiology / Q000517:prevention & control
D004967:Estrogens; D004958:Estradiol; D012968:Etidronic Acid; D002118:Calcium; D019386:Alendronate