Cost-effectiveness of vitamin D and calcium supplementation in the treatment of elderly women and men with osteoporosis

Background: The supplementation with vitamin D and calcium has been recommended for elderly, specifically those with increased risk of fractures older than 65 years. This study aims to assess the cost-effectiveness of vitamin D and calcium supplementation in elderly women and men with osteoporosis and therefore to assess if this recommendation is justified in terms of cost-effectiveness. Methods: A validated model for economic evaluations in osteoporosis was used to estimate the cost per quality-adjusted life-year (QALY) gained of vitamin D/calcium supplementation compared with no treatment. The model was populated with cost and epidemiological data from a Belgian health-care perspective. Analyses were conducted in women and men with a diagnosis of osteoporosis (i.e. bone mineral density T-score <=-2.5). A literature search was conducted to describe the efficacy of vitamin D and calcium in terms of fracture risk reduction. Results: The cost per QALY gained of vitamin D/calcium supplementation was estimated at (sic)40 578 and (sic)23 477 in women and men aged 60 years, respectively. These values decreased to (sic)7912 and (sic)10 250 at the age of 70 years and vitamin D and calcium supplementation was cost-saving at the age of 80 years, meaning that treatment cost was less than the costs of treating osteoporotic fractures of the no-treatment group. Conclusion: This study suggests that vitamin D and calcium supplementation is cost-effective for women and men with osteoporosis aged over 60 years. From an economic perspective, vitamin D and calcium should therefore be administrated in these populations including those also taking other osteoporotic treatments.