title: Health technology assessment in osteoporosis.
abstract: We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands. m.hiligsmann@maastrichtuniversity.nl
authors.forename: Mickael
authors.initials: M
authors.lastname: Hiligsmann
authors.forename: John A
authors.initials: JA
authors.lastname: Kanis
authors.forename: Juliet
authors.initials: J
authors.lastname: Compston
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: Bruno
authors.initials: B
authors.lastname: Flamion
authors.forename: Pierre
authors.initials: P
authors.lastname: Bergmann
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Body
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Olivier
authors.initials: O
authors.lastname: Bruyere
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Devogelaer
authors.forename: Stefan
authors.initials: S
authors.lastname: Goemaere
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Kaufman
authors.forename: Serge
authors.initials: S
authors.lastname: Rozenberg
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D020811:Biomedical Technology / Q000191:economics; D003362:Cost-Benefit Analysis; D050723:Fractures, Bone / Q000191:economics / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D013673:Technology Assessment, Biomedical