Osteoporosis International

, Volume 18, Issue 1, pp 9–23 | Cite as

Cost-effectiveness of the treatment and prevention of osteoporosis—a review of the literature and a reference model

  • N. Zethraeus
  • F. Borgström
  • O. Ström
  • J. A. KanisEmail author
  • B. Jönsson
Position Paper



The purpose of the paper is to update and review the latest developments related to modelling and economic evaluation of osteoporosis in the period 2002–2005 and further to present a reference model for the assessment of the cost-effectiveness of the prevention and treatment of osteoporosis.


The reference model is intended to be used for fracture specific interventions affecting the risk of fracture. An interface version and an extensive description of the model is available on the internet ( and also accessible via the International Osteoporosis Foundation ( The purpose of the reference model is to improve the quality and comparability of cost-effectiveness analysis in the osteoporosis field and to serve as a tool for validation of present and future cost-effectiveness models. The reference model allows the cost-effectiveness analysis to be carried out from a societal perspective including intervention, morbidity and mortality costs. The model has been extensively tested and calibrated, and meets the properties of good decision analytic modelling. The model is a state transition Markov cohort model, which is characterised by a 50-year time horizon divided into one year cycle lengths. The following health states are included: “healthy”, “hip fracture”, “spine fracture”, “wrist fracture”, “other fracture”, and “dead”.


The model is flexible and allows for the estimation of the cost-effectiveness over different ranges for a selected number of variables (e.g., age, fracture risk, cost of intervention).


Cost-effectiveness Osteoporosis Prevention 



Supported in part by a grant from the International Osteoporosis Foundation.


  1. 1.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473PubMedCrossRefGoogle Scholar
  2. 2.
    SBU [The Swedish Council on Technology Assessment in Health Care] (2003) Osteoporos-prevention, diagnostik och behandling [Osteoporosis-prevention, diagnosis and treatment]. SBU, Stockholm, report No 165/1Google Scholar
  3. 3.
    Zethraeus N, Borgström F, Johnell O, Jönsson B (2002) Costs and quality of life associated with osteoporosis related fractures-results based on a Swedish survey. Published in the Working Paper Series in Economics and Finance at the Stockholm School of Economics, Working paper No 512Google Scholar
  4. 4.
    Borgström F, Zethraeus N, Johnell O (2005) Costs and quality of life associated with osteoporosis related fractures in Sweden. Osteopoprosis International (forthcoming 2005)Google Scholar
  5. 5.
    Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson B (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15:20–26PubMedCrossRefGoogle Scholar
  6. 6.
    Sawka AM, Boulos P, Beattie K, Thabane L, Papaioannou A, Gafni A, Cranney A, Zytaruk N, Hanley DA, Adachi JD (2005) Do hip protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. Osteoporos IntGoogle Scholar
  7. 7.
    Total läkemedelsförsäljning (2000–2004) In: Apoteket (ed)Google Scholar
  8. 8.
    Eberhardt S, Stoklossa C, Schulenburg JGvd (2005) Euromet 2004. The influence of economic evaluation studies on health care decision making. A European Study. In: Eberhardt S, Stoklossa C, Graf von der Schulenburg JM (eds). Amsterdam, The NetherlandsGoogle Scholar
  9. 9.
    Fleurence RL, Iglesias CP, Torgerson DJ (2005) Economic evaluations of interventions for the prevention and treatment of osteoporosis: a structured review of the literature. Osteoporos IntGoogle Scholar
  10. 10.
    Johannesson M, Jonsson B (1993) Economic evaluation of osteoporosis prevention. Health Policy 24:103–124PubMedCrossRefGoogle Scholar
  11. 11.
    Zethraeus N, Ben Sedrine W, Caulin F, Corcaud S, Gathon HJ, Haim M, Johnell O, Jonsson B, Kanis JA, Tsouderos Y, Reginster JY (2002) Models for assessing the cost-effectiveness of the treatment and prevention of osteoporosis. Osteoporos Int 13:841–857PubMedCrossRefGoogle Scholar
  12. 12.
    Tosteson AN, Jonsson B, Grima DT, O’Brien BJ, Black DM, Adachi JD (2001) Challenges for model-based economic evaluations of postmenopausal osteoporosis interventions. Osteoporos Int 12:849–857PubMedCrossRefGoogle Scholar
  13. 13.
    Weinstein MC (1980) Estrogen use in postmenopausal women-costs, risks, and benefits. N Engl J Med 303:308–316PubMedCrossRefGoogle Scholar
  14. 14.
    Weinstein MC, Schiff I (1983) Cost-effectiveness of hormone replacement therapy in the menopause. Obstet Gynecol Surv 38:445–455PubMedCrossRefGoogle Scholar
  15. 15.
    Weinstein MC, Tosteson AN (1990) Cost-effectiveness of hormone replacement. Ann N Y Acad Sci 592:162–172, discussion 185–192PubMedCrossRefGoogle Scholar
  16. 16.
    Tosteson AN, Rosenthal DI, Melton LJ 3rd, Weinstein MC (1990) Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 113:594–603PubMedGoogle Scholar
  17. 17.
    Tosteson AN, Weinstein MC (1991) Cost-effectiveness of hormone replacement therapy after the menopause. Baillieres Clin Obstet Gynaecol 5:943–959PubMedCrossRefGoogle Scholar
  18. 18.
    Jönsson B, Hedbrant J, Johnell O (1993) A Computer Simulation Model to Analyse the Cost-effectiveness of Fracture Prevention of Osteoporosis. EFI Research paper Nr 6525Google Scholar
  19. 19.
    Zethraeus N, Johannesson, M, Jönsson, B (1998) A computer model to analyse the cost effectiveness of hormone replacement therapy. EFI Research Paper No 6578Google Scholar
  20. 20.
    Zethraeus N, Lindgren P, Johnell O (2000) A computer model to analyse the cost-effectiveness of hormone replacement therapy-a revised version. SSE/EFI Working Paper Series in Economics and Finance, at the Stockholm School of Economics, Working paper No 368Google Scholar
  21. 21.
    Jonsson B, Kanis J, Dawson A, Oden A, Johnell O (1999) Effect and offset of effect of treatments for hip fracture on health outcomes. Osteoporos Int 10:193–199PubMedCrossRefGoogle Scholar
  22. 22.
    Zethraeus N, Johannesson M, Jonsson B (1999) A computer model to analyze the cost-effectiveness of hormone replacement therapy. Int J Technol Assess Health Care 15:352–365PubMedGoogle Scholar
  23. 23.
    Johnell O, Jonsson B, Jonsson L, Black D (2003) Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314PubMedCrossRefGoogle Scholar
  24. 24.
    Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. Jama 288:321–333PubMedCrossRefGoogle Scholar
  25. 25.
    Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, Bonds D, Brunner R, Brzyski R, Caan B, Chlebowski R, Curb D, Gass M, Hays J, Heiss G, Hendrix S, Howard BV, Hsia J, Hubbell A, Jackson R, Johnson KC, Judd H, Kotchen JM, Kuller L, LaCroix AZ, Lane D, Langer RD, Lasser N, Lewis CE, Manson J, Margolis K, Ockene J, O’Sullivan MJ, Phillips L, Prentice RL, Ritenbaugh C, Robbins J, Rossouw JE, Sarto G, Stefanick ML, Van Horn L, Wactawski-Wende J, Wallace R, Wassertheil-Smoller S (2004) Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. Jama 291:1701–1712PubMedCrossRefGoogle Scholar
  26. 26.
    Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E (1998) Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. Jama 280:605–613PubMedCrossRefGoogle Scholar
  27. 27.
    Melton LJ 3rd, Kan SH, Wahner HW, Riggs BL (1988) Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol 41:985–994PubMedCrossRefGoogle Scholar
  28. 28.
    Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194PubMedCrossRefGoogle Scholar
  29. 29.
    Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Bmj 312:1254–1259PubMedGoogle Scholar
  30. 30.
    Bagger YZ, Tanko LB, Alexandersen P, Hansen HB, Qin G, Christiansen C (2005) The long-term predictive value of bone mineral density measurements for fracture risk is independent of the site of measurement and the age at diagnosis: results from the Prospective Epidemiological Risk Factors study. Osteoporos Int 1–7Google Scholar
  31. 31.
    Meltzer D (1997) Accounting for future costs in medical cost-effectiveness analysis. J Health Econ 16:33–64PubMedCrossRefGoogle Scholar
  32. 32.
    Gold M, Siegel, J, Russell, L (1996) Cost-effectiveness in health and medicine. Oxford University Press, New YorkGoogle Scholar
  33. 33.
    Borgstrom F, Johnell O, Jonsson B, Zethraeus N, Sen SS (2004) Cost effectiveness of alendronate for the treatment of male osteoporosis in Sweden. Bone 34:1064–1071PubMedCrossRefGoogle Scholar
  34. 34.
    Borgstrom F, Johnell O, Kanis JA, Oden A, Sykes D, Jonsson B (2004) Cost effectiveness of raloxifene in the treatment of osteoporosis in Sweden: an economic evaluation based on the MORE study. Pharmacoeconomics 22:1153–1165PubMedCrossRefGoogle Scholar
  35. 35.
    Brecht JG, Kruse HP, Felsenberg D, Mohrke W, Oestreich A, Huppertz E (2003) Pharmacoeconomic analysis of osteoporosis treatment with risedronate. Int J Clin Pharmacol Res 23:93–105PubMedGoogle Scholar
  36. 36.
    Brecht JG, Kruse HP, Mohrke W, Oestreich A, Huppertz E (2004) Health-economic comparison of three recommended drugs for the treatment of osteoporosis. Int J Clin Pharmacol Res 24:1–10PubMedGoogle Scholar
  37. 37.
    Christensen PM, Brixen K, Gyrd-Hansen D, Kristiansen IS (2005) Cost-effectiveness of alendronate in the prevention of osteoporotic fractures in Danish women. Basic Clin Pharmacol Toxicol 96:387–396PubMedCrossRefGoogle Scholar
  38. 38.
    Fleurence RL (2004) Cost-effectiveness of fracture prevention treatments in the elderly. Int J Technol Assess Health Care 20:184–191PubMedCrossRefGoogle Scholar
  39. 39.
    Grima, Burge, Tosteson (2002) Short-term cost-effectiveness of bisphosphonate therapies for postmenopausal osteoporotic somen at high risk of fracture. 27:448–455Google Scholar
  40. 40.
    Iglesias CP, Torgerson DJ, Bearne A, Bose U (2002) The cost utility of bisphosphonate treatment in established osteoporosis. Qjm 95:305–311PubMedCrossRefGoogle Scholar
  41. 41.
    Jonsson L, Borgstrom F, Zethraeus N (2003) [Cost-effectiveness of alendronate treatment of osteoporosis in Denmark. An economic evaluation based on the Fracture Intervention Trial]. Ugeskr Laeger 165:4112–4116PubMedGoogle Scholar
  42. 42.
    Kanis JA, Borgstrom F, Johnell O, Jonsson B (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int 15:862–871PubMedCrossRefGoogle Scholar
  43. 43.
    Kanis JA, Borgstrom F, Johnell O, Oden A, Sykes D, Jonsson B (2005) Cost-effectiveness of raloxifene in the UK: an economic evaluation based on the MORE study. Osteoporos Int 16:15–25PubMedCrossRefGoogle Scholar
  44. 44.
    Kanis JA, Brazier JE, Stevenson M, Calvert NW, Lloyd Jones M (2002) Treatment of established osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 6:1–146PubMedGoogle Scholar
  45. 45.
    Lundkvist J, Johnell O, Cooper C, Sykes D (2005) Economic evaluation of parathyroid hormone (PTH) in the treatment of osteoporosis in postmenopausal women. Osteoporos IntGoogle Scholar
  46. 46.
    Nagata-Kobayashi S, Shimbo T, Fukui T (2002) Cost-effectiveness analysis of screening for osteoporosis in postmenopausal Japanese women. J Bone Miner Metab 20:350–357PubMedCrossRefGoogle Scholar
  47. 47.
    Schousboe JT, Nyman JA, Kane RL, Ensrud KE (2005) Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women. Ann Intern Med 142:734–741PubMedGoogle Scholar
  48. 48.
    Segui-Gomez M, Keuffel E, Frick KD (2002) Cost and effectiveness of hip protectors among the elderly. Int J Technol Assess Health Care 18:55–66PubMedGoogle Scholar
  49. 49.
    Singh S, Sun H, Anis AH (2004) Cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents. J Rheumatol 31:1607–1613PubMedGoogle Scholar
  50. 50.
    Stevenson M, Lloyd Jones M, De Nigris E, Brewer N, Davis S, Oakley J (2005) A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess 9:1–160PubMedGoogle Scholar
  51. 51.
    Waldegger L, Cranney A, Man-Son-Hing M, Coyle D (2003) Cost-effectiveness of hip protectors in institutional dwelling elderly. Osteoporos Int 14:243–250PubMedGoogle Scholar
  52. 52.
    Willis MS (2002) The health economics of calcium and vitamin D3 for the prevention of osteoporotic hip fractures in Sweden. Int J Technol Assess Health Care 18:791–807PubMedCrossRefGoogle Scholar
  53. 53.
    Zethraeus N, Borgstrom F, Jonsson B, Kanis J (2005) Reassessment of the cost-effectiveness of hormone replacement therapy in Sweden: Results based on the Women’s Health Initiative randomized controlled trial. Int J Technol Assess Health Care 21:433–441PubMedCrossRefGoogle Scholar
  54. 54.
    Borgstrom F, Zethraeus N (2003) [Economic assessment based on a clinical study of risedronate. Fracture prevention in elderly women with osteoporosis is cost-effective]. Lakartidningen 100:36–40PubMedGoogle Scholar
  55. 55.
    Johannesson M, Hedbrant J, Jonsson B (1991) A computer simulation model for cost-effectiveness analysis of cardiovascular disease prevention. Med Inform (Lond) 16:355–362Google Scholar
  56. 56.
    Kanis JA, Johnell O, Oden A, Borgstrom F, Johansson H, De Laet C, Jonsson B (2005) Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden. Osteoporos Int 16:6–14PubMedCrossRefGoogle Scholar
  57. 57.
    Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRefGoogle Scholar
  58. 58.
    Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561PubMedCrossRefGoogle Scholar
  59. 59.
    Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882PubMedCrossRefGoogle Scholar
  60. 60.
    Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMedGoogle Scholar
  61. 61.
    Jalava T, Sarna S, Pylkkanen L, Mawer B, Kanis JA, Selby P, Davies M, Adams J, Francis RM, Robinson J, McCloskey E (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1260PubMedCrossRefGoogle Scholar
  62. 62.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112PubMedCrossRefGoogle Scholar
  63. 63.
    Parker MJ, Anand JK (1991) What is the true mortality of hip fractures? Public Health 105:443–446PubMedCrossRefGoogle Scholar
  64. 64.
    Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42PubMedCrossRefGoogle Scholar
  65. 65.
    Oden A, Dawson A, Dere W, Johnell O, Jonsson B, Kanis JA (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8:599–603PubMedCrossRefGoogle Scholar
  66. 66.
    Statistics Sweden. Sweden’s Statistical Databases. In http://wwwscbse/eng/databaser/ssdasp
  67. 67.
    Zethraeus N, Borgström F, Johnell O, Kanis J, Jönsson B (2002) Costs and Quality of Life Associated with Osteoporosis Related Fractures-Results from a Swedish Survey. Working Paper Series in Economics and Finance, 512Google Scholar
  68. 68.
    Burstrom K, Johannesson M, Diderichsen F (2001) Swedish population health-related quality of life results using the EQ-5D. Qual Life Res 10:621–635PubMedCrossRefGoogle Scholar
  69. 69.
    Kind P, Dolan P, Gudex C, Williams A (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. Br Med J 316:736–741Google Scholar
  70. 70.
    Jonsson B, Christiansen C, Johnell O, Hedbrandt J, Karlsson G (1996) Cost-effectiveness of fracture prevention in established osteoporosis. Scand J Rheumatol Suppl 103:30–38PubMedCrossRefGoogle Scholar
  71. 71.
    Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedCrossRefGoogle Scholar
  72. 72.
    Zethraeus N, Stromberg L, Jonsson B, Svensson O, Ohlen G (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68:13–17PubMedCrossRefGoogle Scholar
  73. 73.
    Stockholms stads budgetavräkning 2003 [online]. InGoogle Scholar
  74. 74.
    Ekman M, Zethraeus N, Dahlstrom U (2002) Cost-effectiveness of bisoprolol in chronic heart failure. Lakartidningen 99(7):646–650PubMedGoogle Scholar
  75. 75.
    Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348:1535–1541PubMedCrossRefGoogle Scholar
  76. 76.
    Lauritzen JB, Petersen MM, Lund B (1993) Effect of external hip protectors on hip fractures. Lancet 341:11–13PubMedCrossRefGoogle Scholar
  77. 77.
    McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340PubMedCrossRefGoogle Scholar
  78. 78.
    Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. Jama 282:637–645PubMedCrossRefGoogle Scholar
  79. 79.
    WHO (1999) Recommendations for health economics evaluations of interventions in osteoporosis. WHO Collaborating Centre for Public Health Aspects of Osteoporosis and other Rheumatic Diseases, Liège, BelgiumGoogle Scholar
  80. 80.
    LFN [the Swedish drug benefits board]. General guidelines for the economic evaluation from pharmaceutical benefits board. LFNAR 2003:2Google Scholar
  81. 81.
    Zethraeus N, Johannesson M, Henriksson P, Strand RT (1997) The impact of hormone replacement therapy on quality of life and willingness to pay. Br J Obstet Gynaecol 104:1191–1195PubMedGoogle Scholar
  82. 82.
    Daly E, Gray A, Barlow D, McPherson K, Roche M, Vessey M (1993) Measuring the impact of menopausal symptoms on quality of life. Bmj 307:836–840PubMedCrossRefGoogle Scholar
  83. 83.
    Akehorst RPA, Brazier J (2000) Decision analytic modelling in the economic evaluation of health technologies. A consensus statement. Pharmacoeconomics 17:443–444CrossRefGoogle Scholar
  84. 84.
    Sculpher M, Fenwick E, Claxton K (2000) Assessing quality in decision analytic cost-effectiveness models. A suggested framework and example of application. Pharmacoeconomics 17:461–477PubMedCrossRefGoogle Scholar
  85. 85.
    Briggs AH (2000) Handling uncertainty in cost-effectiveness models. Pharmacoeconomics 17:479–500PubMedCrossRefGoogle Scholar
  86. 86.
    Johannesson M (2001) At what coronary risk level is it cost-effective to initiate cholesterol lowering drug treatment in primary prevention? Eur Heart J 22:919–925PubMedCrossRefGoogle Scholar
  87. 87.
    Almbrand B, Johannesson M, Sjostrand B, Malmberg K, Ryden L (2000) Cost-effectiveness of intense insulin treatment after acute myocardial infarction in patients with diabetes mellitus; results from the DIGAMI study. Eur Heart J 21:733–739PubMedCrossRefGoogle Scholar
  88. 88.
    National Osteoporosis Foundation (1998) Osteoporosis: Review of the Evidence for Prevention, Diagnosis and Treatment and Cost-Effective Analysis. Osteoporosis International 8(Suppl 4):1–88Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  • N. Zethraeus
    • 1
  • F. Borgström
    • 2
    • 4
  • O. Ström
    • 2
  • J. A. Kanis
    • 3
    Email author
  • B. Jönsson
    • 1
  1. 1.Centre for Health EconomicsStockholm School of EconomicsStockholmSweden
  2. 2.Stockholm Health EconomicsStockholmSweden
  3. 3.Centre for Metabolic Bone Diseases (WHO Collaborating Centre)University of Sheffield Medical School, UKSheffieldUK
  4. 4.Medical Management Centre at the Karolinska Institute (KI)StockholmSweden

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