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PURPOSE: To comment on the latest technology appraisal of the National Institute for Clinical Excellence (NICE) in osteoporosis. METHODS: Review of NICE Technology Appraisal (TA464) on bisphosphonate use in osteoporosis. RESULTS: The NICE appraisal on bisphosphonate use in osteoporosis indicates that treatment with oral bisphosphonates may be instituted at a FRAX 10-year probability of major osteoporotic fracture above 1%. Implementation would mean that all women aged 50 years or older are deemed eligible for treatment, a position that would increase the burden of rare long-term side effects across the population. CONCLUSION: Cost-effectiveness thresholds for low-cost interventions should not be used to set intervention thresholds but rather to validate the implementation of clinically driven intervention thresholds.

Original publication




Journal article


Osteoporos int

Publication Date





1511 - 1513


Cost-effectiveness, FRAX, Intervention thresholds, National Institute for Clinical Excellence, National Osteoporosis Guideline Group, Osteoporosis