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• W2153538330 abstract "To establish the clinical effectiveness and cost-effectiveness of selective oestrogen receptor modulators, bisphosphonates and parathyroid hormone (subject to licensing) for the prevention and treatment of osteoporosis and the prevention of osteoporotic fractures in postmenopausal women.Electronic databases.Studies that met the review's entry criteria were eligible for inclusion in the meta-analyses provided that they reported fracture incidence in terms of the number of patients suffering fractures. Meta-analysis was carried out using the random-effects model. A model was constructed to estimate the cost-effectiveness of osteoporosis interventions. The model calculated the number of fractures that occurred and provided the costs associated with osteoporotic fractures, and the quality-adjusted life-years (QALYs). In addition, the conditions of breast cancer and coronary heart disease (CHD) were modelled, as some interventions have been shown to affect the risk of these conditions.Ninety randomised controlled trials (RCTs) met the inclusion criteria. They related to the five interventions (alendronate, etidronate, risedronate, raloxifene and teriparatide) and to five comparators (calcium, calcium plus vitamin D, calcitriol, hormone replacement therapy and exercise), as well as placebo or no treatment. All five interventions have been shown to reduce the risk of vertebral fracture in women with severe osteoporosis with adequate calcium intakes. However, none of these drugs has been demonstrated, by direct comparison, to be significantly more effective than either each other or the other active interventions reviewed in this report. The intervention costs of treating all osteoporotic women, for a period of 5 years, were in the region of pound 900-1500 million for alendronate, etidronate, risedronate and raloxifene. The cost per QALY ratios fell dramatically with age. Assuming the risks of a woman with severe osteoporosis at the threshold of osteoporosis, no treatment had a cost per QALY below pound 35,000 at 50 years of age. At 60 years of age, the cost per QALY of raloxifene was pound 26,000 assuming no impact on hip fractures, and pound 31,000 assuming an adverse effect. However, these results are driven by the effect on breast cancer and the assumptions made regarding this disease state. No other intervention had a cost per QALY below pound 35,000. When analyses were conducted assuming that the fracture risk is doubled at each site, alendronate and risedronate had cost per QALY ratios below pound 30,000 at all ages. For women at the threshold of osteoporosis, without a prior fracture and aged 70 years, the cost per QALY of the three bisphosphonates ranged from pound 34,000 to pound 41,000. Raloxifene had a cost per QALY of pound 23,000, assuming no effect on hip fracture, given assumptions regarding breast cancer. At 80 years of age, the cost per QALY of alendronate and risedronate was below pound 20,000. This was true for etidronate when incorporating observational data, but the value rose to pound 69,000 when only RCT data were used. No other intervention had a cost per QALY below pound 35,000. It was assumed that doubling the risk of fracture for women without a prior fracture would give results similar to patients at the threshold of osteoporosis with a prior fracture.Of the five interventions, only raloxifene appeared to reduce the risk of vertebral fracture in postmenopausal women unselected for low bone mineral density (BMD). However, as the full data have not been made public, there is some uncertainty regarding this result. None of the five interventions has been shown to reduce the risk of non-vertebral fracture in women unselected for low BMD. All of the proposed interventions provided gains in QALYs compared with no treatment in women with sufficient calcium and vitamin D intakes. The size of the QALY gain for each intervention was strongly related to the age of the patient. The estimated costs varied widely for the interventions. These net costs were markedly different by age, with some interventions becoming cost-saving at higher age ranges in patients with a prior fracture. Areas for future research include: the evidence base for the efficacy of fracture prevention in the very elderly, reanalysis of raloxifene using a dedicated breast cancer and CHD model, and more trials considering the cost-effectiveness of teriparatide." @default.
• W2153538330 created "2016-06-24" @default.
• W2153538330 creator A5016313864 @default.
• W2153538330 creator A5017689741 @default.
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• W2153538330 creator A5052330918 @default.
• W2153538330 creator A5075838019 @default.
• W2153538330 date "2005-06-01" @default.
• W2153538330 modified "2023-10-10" @default.
• W2153538330 title "A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis" @default.
• W2153538330 cites W110053699 @default.
• W2153538330 cites W1492612191 @default.
• W2153538330 cites W1494188382 @default.
• W2153538330 cites W1512398135 @default.
• W2153538330 cites W1526826623 @default.
• W2153538330 cites W1551414180 @default.
• W2153538330 cites W1564323166 @default.
• W2153538330 cites W1576813196 @default.
• W2153538330 cites W1593173821 @default.
• W2153538330 cites W1593442063 @default.
• W2153538330 cites W168150526 @default.
• W2153538330 cites W1774945280 @default.
• W2153538330 cites W1944723793 @default.
• W2153538330 cites W1963783263 @default.
• W2153538330 cites W1964001203 @default.
• W2153538330 cites W1965209482 @default.
• W2153538330 cites W1966269436 @default.
• W2153538330 cites W1966391931 @default.
• W2153538330 cites W1966813919 @default.
• W2153538330 cites W1967461894 @default.
• W2153538330 cites W1968418396 @default.
• W2153538330 cites W1968757839 @default.
• W2153538330 cites W1969383313 @default.
• W2153538330 cites W1970028985 @default.
• W2153538330 cites W1970400080 @default.
• W2153538330 cites W1972391190 @default.
• W2153538330 cites W1974157576 @default.
• W2153538330 cites W1975693675 @default.
• W2153538330 cites W1977065585 @default.
• W2153538330 cites W1980925376 @default.
• W2153538330 cites W1985504487 @default.
• W2153538330 cites W1985992498 @default.
• W2153538330 cites W1986238913 @default.
• W2153538330 cites W1986364825 @default.
• W2153538330 cites W198876260 @default.
• W2153538330 cites W1989785305 @default.
• W2153538330 cites W1991189958 @default.
• W2153538330 cites W1991405324 @default.
• W2153538330 cites W1992279725 @default.
• W2153538330 cites W1992925779 @default.
• W2153538330 cites W1993277231 @default.
• W2153538330 cites W1993932749 @default.
• W2153538330 cites W1994222210 @default.
• W2153538330 cites W1994338284 @default.
• W2153538330 cites W1994561005 @default.
• W2153538330 cites W1996336099 @default.
• W2153538330 cites W1996909898 @default.
• W2153538330 cites W1997883187 @default.
• W2153538330 cites W1998331007 @default.
• W2153538330 cites W2000182266 @default.
• W2153538330 cites W2001987600 @default.
• W2153538330 cites W2002672841 @default.
• W2153538330 cites W2004069410 @default.
• W2153538330 cites W2004302812 @default.
• W2153538330 cites W2005298224 @default.
• W2153538330 cites W2006021879 @default.
• W2153538330 cites W2006478466 @default.
• W2153538330 cites W2006585716 @default.
• W2153538330 cites W2007220536 @default.
• W2153538330 cites W20072464 @default.
• W2153538330 cites W2007464845 @default.
• W2153538330 cites W2007957466 @default.
• W2153538330 cites W2011658516 @default.
• W2153538330 cites W2017454985 @default.
• W2153538330 cites W2017707906 @default.
• W2153538330 cites W2019132764 @default.
• W2153538330 cites W2020851272 @default.
• W2153538330 cites W2023338191 @default.
• W2153538330 cites W2024347897 @default.
• W2153538330 cites W2024975817 @default.
• W2153538330 cites W2027473735 @default.
• W2153538330 cites W2028655493 @default.
• W2153538330 cites W2029180490 @default.
• W2153538330 cites W2029872562 @default.
• W2153538330 cites W2032946274 @default.
• W2153538330 cites W2033238186 @default.
• W2153538330 cites W2034238658 @default.
• W2153538330 cites W2035593552 @default.
• W2153538330 cites W2036125852 @default.
• W2153538330 cites W2036257783 @default.
• W2153538330 cites W2037040844 @default.
• W2153538330 cites W2037042646 @default.
• W2153538330 cites W2039010341 @default.
• W2153538330 cites W2039275783 @default.
• W2153538330 cites W2039860789 @default.
• W2153538330 cites W2040572460 @default.
• W2153538330 cites W2040645421 @default.
• W2153538330 cites W2041144723 @default.
• W2153538330 cites W2041492652 @default.

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