Osteoporosis International

, Volume 17, Issue 1, pp 29–40

Economic evaluations of interventions for the prevention and treatment of osteoporosis: a structured review of the literature

  • Rachael L. Fleurence
  • Cynthia P. Iglesias
  • David J. Torgerson

DOI: 10.1007/s00198-005-1943-z

Cite this article as:
Fleurence, R.L., Iglesias, C.P. & Torgerson, D.J. Osteoporos Int (2006) 17: 29. doi:10.1007/s00198-005-1943-z


Economic evaluations are increasingly being used by decision-makers to estimate the cost-effectiveness of interventions. The objective of this study was to conduct a structured review of economic evaluations of interventions to prevent and treat osteoporosis. Articles were identified independently by two reviewers through searches on MEDLINE, the bibliographies of reviews and identified economic models, and expert opinion, using predefined inclusion and exclusion criteria. Data on country, type and level of interventions, type of fractures, interventions, study population and the authors’ stated conclusions were extracted. Forty-two relevant studies were identified. The majority of studies (71%) were conducted in Sweden, the UK and the US. The main interventions investigated were hormone replacement therapy (27%), bisphosphonates (17%) and combinations of vitamin D and calcium (16%). In 38% of studies, hip fracture was the sole fracture outcome. Eighty-eight percent (88%) of studies investigated female populations only. A relatively large number of economic evaluations were identified in the field of osteoporosis. Major changes have recently occurred in the treatment of this disease, following the publication of the results of the Women’s Health Initiative trial. Methodological developments in economic evaluations, such as the use of probabilistic sensitivity analysis and cost-effectiveness acceptability curves, have also taken place. Such changes are reflected in the studies that were reviewed. The development of economic models should be an iterative process that incorporates new information, whether clinical or methodological, as it becomes available.


Cost-effectiveness Economics Fractures Model Osteoporosis Review 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • Rachael L. Fleurence
    • 1
    • 3
  • Cynthia P. Iglesias
    • 2
  • David J. Torgerson
    • 2
  1. 1.The MEDTAP Institute at UBCBethesdaUSA
  2. 2.Department of Health SciencesUniversity of YorkYorkUK
  3. 3.BethesdaUSA

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