A cost effectiveness analysis of calcium and vitamin D supplementation, etidronate, and alendronate in the prevention of vertebral fractures in women treated with glucocorticoids.

摘要: OBJECTIVE: To assess the relative costs and benefits of calcium vitamin D supplements, cyclic etidronate, or alendronate in prevention vertebral fractures for women with normal bone density osteopenia who are about to initiate moderate dose glucocorticoid treatment. METHODS: Using a decision analysis model, we evaluated following patients: 4 hypothetical cohorts: 30-yr-old lumbar spine (LS) mineral (BMD) (t score = 0), 50-yr-old borderline -1), 60-yr-old -1.5), 70-yr-old severe -2) treated mean prednisone 10 mg/day one year. The main outcomes included development years after treatment at age 80 (life-time risk) direct indirect costs. RESULTS: At years, supplements decreased fracture rates by 30-50% minimal cost (US$800 less per avoided) saving compared no -1 -2). Etidronate most effective osteoporosis scores -1.5 year analysis. In life-time analysis, yielded savings all groups osteopenia. further than $2,000 prevented. Alendronate reduced risk $3,000-7,000 avoided. CONCLUSION: Calcium low bisphosphonate regimens such as etidronate decrease acceptable should be considered when initiating do not have osteoporosis.