title: The cost-effectiveness of risedronate treatment in Japanese women with osteoporosis.
abstract: We constructed a mathematical model for assessing the cost-effectiveness of providing BMD (bone mineral density) scans to Japanese women aged 55 years and over and treating, with risedronate, those that are shown to be osteoporotic. Fracture rates, cost data, utility values, and the increased risks of fractures associated with T-score and vertebral fracture history were taken from published literature. We estimated the cost of fractures avoided due to risedronate treatment, allowing the net changes in cost, incorporating both intervention and fracture costs to be calculated. The QALYs (quality adjusted life years) gained through treatment were calculated enabling cost per QALY ratios to be presented. Further analyses were undertaken assuming treatment was reserved for older women and/or those who had sustained a vertebral fracture in the previous 2 years. Cost per QALY values were inversely related to absolute risk of fracture. Assuming a cost per QALY value threshold of US dollars 100,000, we concluded that providing BMD scans to women aged 70 years and over who had sustained a vertebral fracture in the previous 2 years and treating those that were osteoporotic was cost-effective. However, providing BMD scans for women without a vertebral fracture in the previous 2 years was not cost-effective, even in women aged 85 years and older.
authors: Department of Health Administration and Policy, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. dinghansheng@mail.tains.tohoku.ac.jp
authors: Hansheng
authors: H
authors: Ding
authors: Nobuo
authors: N
authors: Koinuma
authors: Matt
authors: M
authors: Stevenson
authors: Michiya
authors: M
authors: Ito
authors: Yasutake
authors: Y
authors: Monma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000191:economics / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D000068296:Risedronic Acid
chemical_list: D000068296:Risedronic Acid; D012968:Etidronic Acid