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Hip Fracture Prevention

Cost-Effective Strategies

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Abstract

The available literature on cost benefit, cost effectiveness and cost utility of different drug and non-drug regimens in preventing hip fractures was reviewed.

The cost of a hip fracture and of the different treatment regimens varied considerably from one country to another. In primary prevention, potential savings only exceeded costs in women over the age of 70 years treated with hormonal replacement therapy (HRT). In the case of HRT, treating those with low bone mineral density levels (secondary prevention) seems to be more cost effective than general treatment (primary prevention).

There are few studies that have compared several different preventive regimens. Cost effectiveness is directly related to the cost of the regimen used because there is no significant difference in their effectiveness. That is, a high cost regimen such as bisphosphonates would be less cost effective than a low cost regimen such as HRT, judged from existing literature.

High risk groups can be identified (nursing home residents) and treated with low cost interventions (calcium plus vitamin D or hip protectors). Considerable differences in the estimates used for the efficacy of different regimens in studies exist.

Further studies comparing several hip fracture preventive regimens are required in order to establish the most cost-effective strategy.

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Research librarian, Miss Edith Clausen is acknowledged for skilful technical assistance.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark

    Peter Vestergaard, Lars Rejnmark & Leif Mosekilde

  2. Institute of Clinical Pharmacology, Aarhus University, Aarhus, Denmark

    Lars Rejnmark

  3. The Osteoporosis Clinic, Aarhus Amtssygehus, Tage Hansens Gade 2, DK-8000, Aarhus C, Denmark

    Peter Vestergaard

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Vestergaard, P., Rejnmark, L. & Mosekilde, L. Hip Fracture Prevention. Pharmacoeconomics 19, 449–468 (2001). https://doi.org/10.2165/00019053-200119050-00002

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