Annual BMD, Selective Oral Bisphosphonate Use Cost-Effective for Fracture Prevention in Postmenopausal Women Receiving AIs for Hormone-Positive Early Breast Cancer
(ChemotherapyAdvisor) – Baseline and annual bone mineral density (BMD) screening with subsequent selective treatment with oral bisphosphonates where indicated in postmenopausal women receiving adjuvant aromatase inhibitors (AIs) for hormone-receptor early breast cancer is a cost-effective use of societal resources, a study in the Journal of Clinical Oncology published online February 27 has found.
The investigators compared the cost effectiveness of no intervention; one-time and annual BMD screening and selective bisphosphonate therapy in women with osteoporosis or osteopenia; and universal bisphosphonate therapy for fracture prevention. A model was developed to simulate clinical practice and outcomes in a hypothetical cohort of women age 60 years who were starting a five-year course of AI therapy after primary surgery for breast cancer.
The incremental cost-effectiveness for annual BMD screening followed by oral bisphosphonates for those with osteoporosis was $87,300; annual BMD screening followed by oral bisphosphonates for those with osteopenia was $129,300; and universal treatment with oral bisphosphonates was $283,600 per quality-adjusted life-years gained.
“Future fracture prevention guidelines should address the optimal use of bisphosphonates based on not only their ability to preserve BMD but also their potential to improve breast cancer outcomes,” the investigators concluded.