Evidence map›Paper›PMID 38619605›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

The cost-effectiveness of osteoporosis medications for preventing periprosthetic fractures following femoral neck fracture indicated hip arthroplasty: a break-even analysis.

Amil R Agarwal, Matthew J Kinnard, Christopher Murdock, Amy Y Zhao, Uzoma Ahiarakwe, Jordan S Cohen, Kendall F Moseley, Gregory J Golladay, Savyasachi C Thakkar

Abstract read
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
  3. [Research progress on treatment of unstable intertrochanteric fractures in elderly patients with bone cement type femoral head replacement].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Amil R AgarwalDepartment of Orthopaedic Surgery, George Washington University, Washington, DC, USA.
Matthew J KinnardDepartment of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Christopher MurdockDepartment of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Amy Y ZhaoDepartment of Orthopaedic Surgery, George Washington University, Washington, DC, USA. zhaoa@gwmail.gwu.edu.ORCID http://orcid.org/0000-0002-0494-4223
Uzoma AhiarakweDepartment of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Jordan S CohenDepartment of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PD, USA.
Kendall F MoseleyDepartment of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Gregory J GolladayDepartment of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Savyasachi C ThakkarDepartment of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University · USGeorge Washington University · USGeorge Washington University Hospital · USUniversity of Pennsylvania · USVirginia Commonwealth University · USWalter Reed National Military Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF). Our study evaluated the economic viability of treatment in patients following arthroplasty and demonstrates that treatment with oral bisphosphonates can be cost-effective in preventing PPF.

introductionOsteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF). Although cost-effective in reducing the rate of secondary fragility fracture, the economic viability of osteoporosis treatment in preventing PPF has not been evaluated. Therefore, the purpose of this study is to use a break-even analysis to determine whether and which current osteoporosis medications are cost-effective in preventing PPF following arthroplasty for FNFs.

methodsThree-year average cost of osteoporosis medication (oral bisphosphonates, estrogen hormonal therapy, intravenous (IV) bisphosphonates, denosumab, teriparatide, and abaloparatide), costs of PPF care, and PPF rates in patients who underwent hip arthroplasty for FNFs without osteoporosis treatment were used to perform a break-even analysis. The absolute risk reduction (ARR) related to osteoporosis treatment and sensitivity analyses were used to evaluate the cost-effectiveness of this intervention and break-even PPF rates.

resultsOral bisphosphonate therapy following arthroplasty for hip fractures would be economically justified if it prevents one out of 56 PPFs (ARR, 1.8%). Given the current cost and incidence of PPF, overall treatment can only be economically viable for PPF prophylaxis if the 3-year costs of these agents are less than $1500.

conclusionThe utilization of lower cost osteoporosis medications such as oral bisphosphonates and estrogen hormonal therapy as PPF prophylaxis in this patient population would be economically viable if they reduce the PPF rate by 1.8% and 1.5%, respectively. For IV bisphosphonates and newer agents to be economically viable as PPF prophylaxis in the USA, their costs need to be significantly reduced.

Indexed as

Arthroplasty, Replacement, HipBone Density Conservation AgentsCost-Benefit AnalysisDiphosphonatesDrug CostsFemoral Neck FracturesOsteoporosisPeriprosthetic FracturesAdministration, OralAgedFemaleHealth Care CostsHumansMaleMiddle AgedOsteoporotic FracturesBone Density Conservation AgentsDiphosphonatesBisphosphonatesCost-effectiveOsteoporosisPeriprosthetic fracture

Identifiers

PMID38619605
OpenAlexW4394819906

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.