The effect of alendronate on fracture-related healthcare utilization and costs: The fracture intervention trial

The Vertebral Fracture Arm (VFA) of the Fracture Intervention Trial (FIT) s tudy demonstrated that alendronate reduced the incidence of spine, forearm and hip fractures in women with low bone mass and existing vertebral fractu res by about 50%. The objective of the present study was to determine the e ffects of alendronate therapy versus placebo on fracture-related healthcare utilization and costs. Participants were randomly assigned to double-maske d treatment with alendronate (5 mg/day for 2 years and then 10 mg/day for 1 year) or placebo for 3 years. For each patient experiencing a clinical fra cture, we determined whether treatment in an emergency room, hospital, nurs ing home and/or rehabilitation hospital was a consequence of the fracture. The VFA of the FIT Study enrolled 2027 women aged 55-81 years with low bone mass and pre-existing vertebral fractures from population-based listings i n 11 metropolitan areas of the United States. We measured (1) the proportio n of patients who had any fracture-related healthcare event and (2) the est imated cost of fracture-related healthcare services. Alendronate significan tly reduced the proportion of patients utilizing fracture-related healthcar e (emergency room, hospital, rehabilitation hospital or nursing home) by 25 % (p = 0.038). Alendronate significantly reduced the costs associated with hip-fracture-related care by 58%, or $181 per patient randomized (p = 0.036 ). The reduction in fracture-related total costs was 35% ($190 per patient randomized) in the alendronate group relative to the placebo group (p = 0.1 14). Alendronate thus not only reduces the incidence of clinical fractures and associated morbidity, but reduces the proportion of patients utilizing the associated healthcare resources.