Costs of Treatment: Fracture Prevention in Men Who Receive Androgen-Deprivation Therapy

Accelerated bone loss related to androgen-deprivation therapy (ADT) is a potential problem among men with prostate cancer. Because most of these men receive ADT in the nonmetastatic setting, therapy can be prolonged, thereby raising risk for bone-related morbidity. A number of antiresorptive agents can mitigate ADT-related bone loss, but no agents currently are indicated to lower fracture rates among men in this setting. Moreover, no uniform guidelines exist for monitoring or managing ADT-related bone complications, and the costs and potential side effects of therapy are concerning.

Using a Markov state-transition model that simulated prostate cancer progression and incidence of hip fractures, investigators assessed cost-effectiveness of ost…