绝经后易跌倒骨质疏松症患：者的干预成本-效益研究

目的探索绝经后易跌倒骨质疏松患者干预治疗的成本一效益关系。方法对绝经后高危跌倒患者应用阿仑膦酸钠＋钙尔奇D进行干预，运用Markov模型、增量成本-效益比分析干预后的成本-效益。结果经3年干预治疗后，干预组的腰椎L0-4骨密度为（0．944±0．114）g／cm2，股骨颈骨密度为（0．741±0．153）g／cm2，大转子骨密度为（0．631±0．152）g／cm。，骨密度值均显著性提高。干预3年并运用模型预测10年与对照组相比，治疗组平均每例净节省成本1732元，净增质量调节生命年（qualityadjustedlifeyears，QALYs）0．042年，每获得1个QALY的费用为41238元。结论在抗骨质疏松药物干预成本适度提高的基础上，QALY有所增加，改善了患者生活质量。

Cost-effectiveness Analysis of Alendronate plus Vit D Treatment in the Osteoporotic Postmenopausal Women with High Risk of Falls

Objective To evaluate the Cost-effectiveness of Alendronate with Vit D treatment in the osteoporotic postmenopausal women with high risk of falls. Methods Two hundred osteoporotic postmenopausal women with high risk of falls were divided into treatment group and compare group randomly[age〉60 yrs （68.25＋6.19） yrs, T ≤-2.5 SD, scores of fall ≥ 7]. The Alendronate plus Vit D were used to treat for the treatment group through 3 years. A Markov model was used to evaluate and model the costs and benefits of the treatment for ten years. Results After !3 years＇ Alendronate plus Vit D treatment, the bone mineral density （BMD） of L2-4, femoral neck and greater trochanter in the treatment group was （0.944±0.114） g/cm2, （0.741±0.153） g/cm2 and （0.631 ±0.152） g/cm2 respectively, all these BMD increased significantly than that before the treatment. Compared with none treatment patients, after 10 years model prediction intervention, the treated women of osteoporotic postmenopausal with high risk of falls was spared 1 732 RMB per case, and gained additional 0.042 QALY（quality adjusted life years ）; ICER was estimated at 41 238 RMB per QALY gained. Conclusion Base on the cost rise appropriately of anti-osteoporotic medicine intervention, it can increase the QALY and improve the life quality of the osteoporotic postmenopausal women with high risk of falls.