title: Cost-effectiveness of vitamin D and calcium supplementation in the treatment of elderly women and men with osteoporosis.
abstract: BACKGROUND
  The supplementation with vitamin D and calcium has been recommended for elderly, specifically those with increased risk of fractures older than 65 years. This study aims to assess the cost-effectiveness of vitamin D and calcium supplementation in elderly women and men with osteoporosis and therefore to assess if this recommendation is justified in terms of cost-effectiveness.
  
  
  METHODS
  A validated model for economic evaluations in osteoporosis was used to estimate the cost per quality-adjusted life-year (QALY) gained of vitamin D/calcium supplementation compared with no treatment. The model was populated with cost and epidemiological data from a Belgian health-care perspective. Analyses were conducted in women and men with a diagnosis of osteoporosis (i.e. bone mineral density T-score ≤-2.5). A literature search was conducted to describe the efficacy of vitamin D and calcium in terms of fracture risk reduction.
  
  
  RESULTS
  The cost per QALY gained of vitamin D/calcium supplementation was estimated at €40 578 and €23 477 in women and men aged 60 years, respectively. These values decreased to €7912 and €10 250 at the age of 70 years and vitamin D and calcium supplementation was cost-saving at the age of 80 years, meaning that treatment cost was less than the costs of treating osteoporotic fractures of the no-treatment group.
  
  
  CONCLUSIONS
  This study suggests that vitamin D and calcium supplementation is cost-effective for women and men with osteoporosis aged over 60 years. From an economic perspective, vitamin D and calcium should therefore be administrated in these populations including those also taking other osteoporotic treatments.
authors.affiliation: 1 Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, The Netherlands m.hiligsmann@maastrichtuniversity.nl.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: Wafa
authors.initials: W
authors.lastname: Ben Sedrine
authors.affiliation: 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bruyère
authors.affiliation: 1 Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, The Netherlands.
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Evers
authors.affiliation: 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: Véronique
authors.initials: V
authors.lastname: Rabenda
authors.affiliation: 2 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis / Q000191:economics*; D019587:Dietary Supplements / Q000191:economics*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D014807:Vitamin D / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002118:Calcium