Cost-effectiveness strategies to treat osteoporosis in elderly women
Cost-effectiveness strategies to treat osteoporosis in elderly women
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DOI：
10.1097/01.smj.0000202090.30647.61
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发表时间：
2006-02-01
影响因子：
1.1
通讯作者：
Duerring, Shea A.
中科院分区：
文献类型：
--
作者：
Pfister, Alfred K.;Welch, Christine A.;Duerring, Shea A.
背景资料：比较各种抗骨质疏松药物的成本效益尚未defined.Methods：我们确定了降钙素，雷洛昔芬，双磷酸盐和PTH的成本效益在一个基础病例队列的妇女年龄在65岁或以上的骨质疏松症。骨密度测定后，妇女被分层成治疗组或不治疗。我们的结果目标是每质量调整生命年（QALY）价值10万美元或更少。敏感性分析不同的非椎骨骨折的减少和遵守两个最有效的策略，以测试各种成本每QALY thresholds.Results：双膦酸盐显示最有利的增量成本节约，并防止更多的骨折在我们的基础案例分析。在敏感性分析中，几乎所有的双膦酸盐的值都低于S100，000每QALY和甲状旁腺激素（PTH）之间的S100，000和200，000美元每QALY.Conclusions：只有双膦酸盐是具有成本效益的骨折预防在65岁或以上的女性，这种经济优势也保持在亚组谁有一个较低的相对风险未来骨折。
Background: Comparing the cost-effectiveness of various anticsteoporotic drugs has not been defined.Methods: We determined the cost-effectiveness of calcitonin, raloxifene, bisphosphates and PTH in a base-case cohort of women aged 65 or older with osteoporosis.After bone densitometry, women were stratified into groups of treatment or no treatment. Our outcome goal was a value of $100,000 or less per quality-adjusted life years (QALY). A sensitivity analysis varied nonvertebral fracture reduction and compliance between the two most effective strategies to test various cost per QALY thresholds.Results: Bisphosphonates displayed the most favorable incremental cost saving and prevented more fractures in our base-case analysis. In a sensitivity analysis, virtually all values of bisphosphonates were under S100,000 per QALY and parathyroid hormone (PTH) was between S100,000 and $200,000 per QALY.Conclusions: Only bisphosphonates are cost-effective for fracture prevention in osteoporotic women aged 65 or older and this economic advantage is also maintained in subsets who have a lower relative risk of future fracture.