Osteoporosis is a crippling affliction in which bone mass decreases, making it more susceptible to fracture. In postmenopausal women it presents most often as a hip, spinal, or forearm fracture. Adult women face a 15% lifetime risk of a hip fracture, and the annual costs of hip fractures alone are estimated at $7.3 billion in the United States. Since the 1970s, estrogen/progestogen therapy has been recognized as an effective intervention that reduces the risk of fractures. Recently, the development of methods for accurately determining bone mass and thus helping to predict bone fracture risk has made this intervention attractive for use in a targeted population. This report analyzes the health care costs and calculates the cost savings of coupling bone mineral density screening at the time of menopause with long-term estrogen/progestogen therapy for those most at risk for developing fractures. The model assumes that a cohort of 100,000 American white women, aged 50, are screened for bone mineral density and that 90% of the high-risk group (density less than 0.85 g/cm3) and 70% of the mid-risk group (density between 0.85 and 1.00 g/cm3) elect to take hormone replacement therapy for 15 years. Based on calculations of the costs of screening and hormone replacement therapy, and the savings in cost of treatment and lost productivity from reduced fractures, it is estimated that the present value of savings in cost of illness for this cohort over a 40-year period is $5.1 million.(ABSTRACT TRUNCATED AT 250 WORDS)
A cost-benefit analysis of the impact of cisplatin-based combination chemotherapy for treatment of disseminated testicular cancer showed that the annual estimated economic value of this treatment innovation in the United States is approximately $150 million. The estimate was based on the human capital approach, which conservatively values a human life in terms of economic productivity. Because testicular cancer predominantly strikes young adult males, the savings reported were due to the future earning potential of the survivors. A comparison of relevant National Cancer Institute (NCI) costs for drug development and clinical trials versus annual savings realized indicated that the total costs over a 17-year period are recovered in less than 1 year. This report is an example of health care cost savings resulting from NCI support of biomedical research.
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