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Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women.
J Am Geriatr Soc. 2005 Oct; 53(10):1697-704.JA

Abstract

OBJECTIVES

To investigate the cost-effectiveness of universal bone densitometry in women aged 65 and older combined with alendronate treatment for those diagnosed with osteoporosis (femoral neck T-score < or = -2.5).

DESIGN

A Markov model with a lifetime time horizon and eight health states (no fracture, distal forearm fracture, radiographic (but clinically inapparent) vertebral fracture, clinical vertebral fracture, hip fracture, hip and vertebral fracture, and other fractures), using the societal perspective.

SETTING

Women living independently and those in nursing homes.

PARTICIPANTS

Caucasian women aged 65, 75, 85, or 95.

INTERVENTION

Bone densitometry of the hip, with 5 years of alendronate therapy for those found to have osteoporosis versus no intervention (densitometry or drug therapy).

MEASUREMENTS

Lifetime accumulated quality adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios.

RESULTS

The cost per QALY gained for the screen-and-treat strategy was 43,000 dollars per QALY gained for 65-year-old women and 5,600 dollars per QALY gained for 75-year-old women. For 85- and 95-year-old women, the screen-and-treat strategy was cost saving. Sensitivity analyses showed that the screen-and-treat strategy was cost-effective even under assumptions of reduced adherence to drug therapy, reduced fracture reduction benefit from alendronate therapy, or reduced QALYs saved by preventing fracture.

CONCLUSION

Universal bone densitometry combined with alendronate therapy for those found to have osteoporosis is highly cost-effective for women aged 65 and older and may be cost saving for ambulatory women aged 85 and older (whether independently living or residing in nursing homes).

Authors+Show Affiliations

Park Nicollet Health Services, Minneapolis, Minnesota 55416, USA. schouj@parknicollet.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16181168

Citation

Schousboe, John T., et al. "Universal Bone Densitometry Screening Combined With Alendronate Therapy for Those Diagnosed With Osteoporosis Is Highly Cost-effective for Elderly Women." Journal of the American Geriatrics Society, vol. 53, no. 10, 2005, pp. 1697-704.
Schousboe JT, Ensrud KE, Nyman JA, et al. Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women. J Am Geriatr Soc. 2005;53(10):1697-704.
Schousboe, J. T., Ensrud, K. E., Nyman, J. A., Melton, L. J., & Kane, R. L. (2005). Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women. Journal of the American Geriatrics Society, 53(10), 1697-704.
Schousboe JT, et al. Universal Bone Densitometry Screening Combined With Alendronate Therapy for Those Diagnosed With Osteoporosis Is Highly Cost-effective for Elderly Women. J Am Geriatr Soc. 2005;53(10):1697-704. PubMed PMID: 16181168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women. AU - Schousboe,John T, AU - Ensrud,Kristine E, AU - Nyman,John A, AU - Melton,L Joseph,3rd AU - Kane,Robert L, PY - 2005/9/27/pubmed PY - 2006/1/13/medline PY - 2005/9/27/entrez SP - 1697 EP - 704 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 53 IS - 10 N2 - OBJECTIVES: To investigate the cost-effectiveness of universal bone densitometry in women aged 65 and older combined with alendronate treatment for those diagnosed with osteoporosis (femoral neck T-score < or = -2.5). DESIGN: A Markov model with a lifetime time horizon and eight health states (no fracture, distal forearm fracture, radiographic (but clinically inapparent) vertebral fracture, clinical vertebral fracture, hip fracture, hip and vertebral fracture, and other fractures), using the societal perspective. SETTING: Women living independently and those in nursing homes. PARTICIPANTS: Caucasian women aged 65, 75, 85, or 95. INTERVENTION: Bone densitometry of the hip, with 5 years of alendronate therapy for those found to have osteoporosis versus no intervention (densitometry or drug therapy). MEASUREMENTS: Lifetime accumulated quality adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios. RESULTS: The cost per QALY gained for the screen-and-treat strategy was 43,000 dollars per QALY gained for 65-year-old women and 5,600 dollars per QALY gained for 75-year-old women. For 85- and 95-year-old women, the screen-and-treat strategy was cost saving. Sensitivity analyses showed that the screen-and-treat strategy was cost-effective even under assumptions of reduced adherence to drug therapy, reduced fracture reduction benefit from alendronate therapy, or reduced QALYs saved by preventing fracture. CONCLUSION: Universal bone densitometry combined with alendronate therapy for those found to have osteoporosis is highly cost-effective for women aged 65 and older and may be cost saving for ambulatory women aged 85 and older (whether independently living or residing in nursing homes). SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16181168/Universal_bone_densitometry_screening_combined_with_alendronate_therapy_for_those_diagnosed_with_osteoporosis_is_highly_cost_effective_for_elderly_women_ L2 - https://doi.org/10.1111/j.1532-5415.2005.53504.x DB - PRIME DP - Unbound Medicine ER -