Schousboe John T
Park Nicollet Osteoporosis Center, Park Nicollet Health Services, 3800 Park Nicollet Blvd., Minneapolis, MN 55416, USA.
Curr Rheumatol Rep. 2007 Apr;9(1):50-6. doi: 10.1007/s11926-007-0022-1.
Osteoporotic fractures are common among postmenopausal women and elderly men, and they cause substantial direct medical costs and loss of quality of life. The potential costs of widespread intervention strategies to reduce the incidence of fractures are also quite high. Therefore, the cost-effectiveness of such interventions is highly significant to large-scale health insurers and healthcare systems. Most modeling studies to date have examined the cost-effectiveness of pharmacologic treatment for subsets of postmenopausal women selected on the basis of bone mineral density and/or prevalent vertebral fracture. They generally suggest that oral bisphosphonates and raloxifene are cost-effective therapies for these subsets. Increasingly, modeling studies of treatments for those selected on the basis of absolute fracture risk rather than bone density criteria are being done to establish absolute fracture risk thresholds at which various treatments are cost-effective.
骨质疏松性骨折在绝经后女性和老年男性中很常见，会导致大量直接医疗费用和生活质量下降。广泛实施干预策略以降低骨折发生率的潜在成本也相当高。因此，此类干预措施的成本效益对大型健康保险公司和医疗保健系统至关重要。迄今为止，大多数建模研究都考察了基于骨密度和/或既往椎体骨折情况挑选出的绝经后女性亚组接受药物治疗的成本效益。这些研究通常表明，口服双膦酸盐和雷洛昔芬对这些亚组而言是具有成本效益的疗法。越来越多基于绝对骨折风险而非骨密度标准挑选人群进行治疗的建模研究正在开展，以确定各种治疗具有成本效益的绝对骨折风险阈值。
