Common Questions
How do I know if an osteoporosis treatment will be cost effective in my patient?
Treatment nomograms offer a more precise means of identifying if your contemplated treatment strategy is cost effective for your patient. Treatment nomograms were developed by the NOF for HRT, for alendronate and for calcitonin (1). In order to identify the appropriate nomogram you will need to know:
- Treatment being considered
- History of prior vertebral fracture
- History of prior non-vertebral fracture
Once the appropriate nomogram has been selected the patient's age, T-score and number of risk factors are triangulated placing the patient either above or below the treatment threshold. All women below the risk factor line should be treated. the following is a treatment nomograms for 5 years of treatment with HRT in postmenopausal white women with vertebral fracture:
Your patient is indicated by a star.
Your patient has now had a vertebral fracture, has no risk factors, and her T-score falls below the treatment threshold line. All women below this line should be treated. Thus, treatment with HRT might be appropriate at this time. For comparison, look at how the nomograms vary based on fracture history.
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