ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Cost-effectiveness of FRAX®-based intervention thresholds for management of osteoporosis in Indian women: a Markov microsimulation model analysis.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Cost-effectiveness thresholds for initiating osteoporosis treatment in postmenopausal women in China: a microsimulation analysis based on real-world data.Archives of osteoporosis · 2026Article
- Revolutionizing osteoporosis management: the emerging role of immunotherapeutic and next-generation therapies.Inflammopharmacology · 2025Review
- LncRNA NR2F1-AS1 is involved in osteogenic differentiation in fracture healing via miR-423-5p.Cytotechnology · 2025Article
- Association between bone mineral density T-score and respiratory sarcopenia in older adults.Frontiers in medicine · 2025Article
- Changing Concepts in Osteoporosis Management and their Relevance to India.Indian journal of endocrinology and metabolismArticle
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Abstract
A cost-effectiveness analysis of FRAX® intervention thresholds (ITs) in Indian women over 50 years indicated that generic alendronate was cost-effective for age-dependent major osteoporotic fracture (MOF) ITs and hip fracture (HF) ITs starting at ages 60 and 65 years for full and real-world adherence, respectively. Alendronate was cost-effective at fixed MOF IT of 14% and HF IT of 3.5%, regardless of age. PURPOSE: Osteoporosis represents a significant public health challenge in India, with an increasing economic burden due to the aging population. This study evaluated the cost-effectiveness of using fracture risk assessment tool (FRAX®)-based intervention thresholds (ITs) for managing osteoporosis with generic alendronate in Indian women.
methodsA Markov microsimulation model, adapted to the Indian healthcare context, was used to simulate the costs and quality-adjusted life years (QALYs) associated with different treatment strategies. The one-time gross domestic product (GDP) per capita (estimated at INR 1,97,468/QALY gained) was used as the cost-effectiveness threshold.
resultsThe model revealed that generic alendronate is cost-effective for major osteoporotic fracture (MOF) ITs beginning at age 60 years with full adherence-incremental cost-effectiveness ratio (ICER) of INR 102,151 per QALY gained, and age 65 with real-world adherence-ICER of INR 28,203 per QALY gained (conversion rate used is 1 US dollar (USD) = INR 83.97 and 1 EURO = INR 92.70). Hip fracture (HF) ITs showed similar cost-effectiveness at ages 60 (ICER of INR 67,144) and was the dominant strategy (i.e., more QALYs for lower costs) at ≥ 65 years. Fixed ITs of 14% for MOF and 3.5% for HF proved cost-effective across all age groups (dominant strategy for ages ≥ 65 years). Limitations of our study include the reliance on fracture incidence data from Singaporean Indians and variability in fracture prevalence across India.
conclusionThe results support the integration of FRAX®-based fixed ITs from the age of 50 years and age-based ones from the age of 65 years in India to optimize resource allocation and improve osteoporosis management.
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