Evidence map›Paper›PMID 42329508›Full record

ArticleArchives of osteoporosis2026

Cost-effectiveness thresholds for initiating osteoporosis treatment in postmenopausal women in China: a microsimulation analysis based on real-world data.

Lijia Cui, Qichao Sun, Xiangjun Yin, Wei Yu, Wanping Cai, Nan Zhao, Lin Chen, Shunyu Tang, Hua Lin, Lu Cui and 15 more

Abstract read
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In one paragraph

Article in Archives of osteoporosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

25 authors.

Lijia Cui *Department of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Qichao Sun *Department of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Xiangjun YinDivision of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Wei YuDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Wanping CaiDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Nan ZhaoMedical Sciences Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Lin ChenDepartment of Wound Repair and Rehabilitation Medicine, State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China.
Shunyu TangDivision of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Hua LinDepartment of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
Lu CuiDivision of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaolan JinDepartment of Endocrinology, Chengdu Military General Hospital, Sichuan Province, Chengdu, China.
Zhongjian XieHunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic DiseasesThe Second Xiangya Hospital of Central South UniversityHunan Province, Changsha, China.
Steven R CummingsSan Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
Zhixin LiNational Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Linhong WangNational Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Qianqian PangDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yue ChiDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Ruizhi JiajueDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Wei LiuDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yan JiangDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Ou WangDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Mei LiDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Xiaoping XingDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Xiang LiDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. lixiang05@pumch.cn.ORCID 0000-0003-1625-5748
Weibo XiaDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. xiaweibo8301@163.com.ORCID 0000-0001-7768-5536

Funding

Beijing Natural Science Foundation 7252109CAMS Innovation Fund for Medical Sciences (CIFMS) 2021-I2M-1-002Independent Research Fund of the State Key Laboratory of Complex, Severe, and Rare Disease 2025-I-PY-007National High Level Hospital Clinical Research Funding 2022-PUMCH-D-006National Key R&D Program of China 2021YFC2501700Noncommunicable Chronic Diseases-National Science and Technology Major Project 2024ZD0532204Peking Union Medical College Hospital Talent Cultivation Program Category D UHB11952the National Natural Science Foundation of China No.81970757the National Natural Science Foundation of China No.82270938the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences 2023-PT320-10
6 · The paper itself

Abstract

This study estimated FRAX PURPOSE: To determine drug-specific FRAX

methodsA validated Markov microsimulation model was used to simulate lifetime costs and quality-adjusted life years (QALYs) of no treatment versus alendronate, zoledronate, denosumab, and teriparatide treatment. Baseline patient characteristics and risk factor distribution were sampled from the largest national osteoporosis survey in mainland China. The analysis was conducted from the societal perspective, applying a willingness-to-pay threshold of USD 13,000 per QALY gained (equivalent to one times China's GDP per capita).

resultsDenosumab was cost-effective at a 10-year major osteoporotic fracture probability of 7% and zoledronate at 12%; neither alendronate nor teriparatide became cost-effective. For denosumab, the cost-effective threshold of 10-year major osteoporotic fracture probability increased with age from 51 to 65 years and then declined in older women, ranging from 5 to 12%. For zoledronate treatment, the cost-effective thresholds of a 10-year major osteoporotic fracture probability were 8% at 51-55 years, 12% at 71-75 years, and 8.5% at 76-80 years.

conclusionsFor Chinese postmenopausal women, denosumab was the most cost-effective treatment, while zoledronate also reached favorable thresholds in selected age groups. Implementing drug-specific FRAX®-guided thresholds may optimize treatment decisions for osteoporosis and support efficient healthcare resource use.

Indexed as

Bone Density Conservation AgentsOsteoporosis, PostmenopausalAgedAged, 80 and overAlendronateChinaCost-Benefit AnalysisCost-Effectiveness AnalysisDenosumabDiphosphonatesFemaleHumansMarkov ChainsMiddle AgedOsteoporotic FracturesQuality-Adjusted Life YearsAlendronateBone Density Conservation AgentsDenosumabDiphosphonatesTeriparatideZoledronic AcidChineseCost-effectivenessFRAXOsteoporosisTreatment

Identifiers

PMID42329508

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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.