Pharmacoeconomic analysis of strategies to treat postmenopausal osteoporosis: a systematic review.

Osteoporosis, especially in postmenopausal women, has a high socioeconomic impact on the individual and on the society. There are several drugs for its prevention and treatment; however, their effectiveness and costs vary considerably. Several economic assessments have been conducted in order to evaluate the most effective strategies. This study aimed at conducting a systematic review of complete economic assessments focusing on the treatment of postmenopausal osteoporosis performed in Brazil and worldwide. Articles about economic assessment of drugs for the treatment of postmenopausal osteoporosis were searched in the PubMed and LILACS databases. In general, bisphosphonates were the most frequently assessed strategies and had the best incremental cost-effectiveness ratios. Hormone therapy, vitamin D and calcium, strontium ranelate, raloxifene, teriparatide, and denosumab were assessed and showed variable results depending on the perspective of the country and the assumptions made for each study. None of the results could be extrapolated to the Brazilian population, which limits their use by decision makers.