COST-EFFECTIVENESS OF PREVENTING HIP-FRACTURES IN THE ELDERLY POPULATION USING VITAMIN-D AND CALCIUM

Recent evidence suggests that vitamin D and calcium can reduce the inc idence of hip fracture amongst elderly women. We estimated the costs o f using either parenteral vitamin D alone, or oral vitamin D plus calc ium, in a number of treatment strategies. These were: all women in a c ommunity setting; women with low body mass index (BMI) in the communit y; women in nursing homes; women with low BMI in nursing homes. The co st per averted fracture amongst women living in the community through the use of parenteral vitamin D alone was pound 946, and the cost per averted hip fracture was pound 2317. Inclusion of calcium significantl y increased the cost to pound 14 240 for any fracture and pound 22 379 for hip fractures. However, targeting either treatment on women with the lowest BMI reduced the cost of averting a hip fracture, as did tar geting women living in nursing homes. After removing cost savings from treatment costs, savings to the NHS occurred for all parenteral vitam in D strategies but only one of the oral vitamin D and calcium strateg ies. Preventing fractures with injectable vitamin D is likely to produ ce savings for the NHS. The addition of calcium will increase costs si gnificantly, unless the intervention is targeted on those at high risk .