Project example 7: Osteoporosis in breast cancer

Project type	Cost-utility analysis
Indication	Osteoporosis in breast cancer
Intervention	Intravenous infusion
Methods	Markov modeling
Countries	UK
Deliverables	Report
Presentations	European Cancer Conference (ECCO), Barcelona 2007. Oral presentation. European Breast Cancer Conference (EBCC), Berlin 2008. Oral presentation. American Society of Clinical Oncology (ASCO), Breast cancer symposium, Washington DC 2008. Oral presentation.

The aim of this project was to estimate the cost-utility of two intravenous biphosphonate treatment strategies to prevent fractures in post-menopausal women with early-stage breast cancer. We developed a Markov model to predict the lifetime incidence of four types of fractures: hip, vertebral, wrist and humerus. The risk of fractures was modeled as a function of bone mineral density. The patient population modeled consisted of breast cancer patients treated with aromatase inhibitors. We analysed two treatment strategies with intravenous zoledronate: either upfront or as salvage therapy. The cost-utility analysis was performed from the perspective of the UK's National Health Service (NHS). The methods and results have been reported in an internal report to the sponsor, and have been presented in oral presentations at three international scientific meetings.