Prevention... but at what price?



I n Canada, one in four women over the age of 50 suffers from osteoporosis, a disease characterized by increased bone fragility leading to an elevated risk of fracture.

In addition to the social costs linked to the effects of the disease, the cost of treating osteoporosis is estimated at nearly two billion dollars per year. It is often claimed that the number of fractures — and their associated treatment cost — could be decreased through better-targeted prevention initiatives.

The simulator has created a virtual population of women over 40 to allow the researchers to evaluate the risk of fractures.

However, to date, no evidence of the cost-effectiveness of such measures has been produced. In order to rectify this situation, and to facilitate decision-making in the Public Health sector, Daniel Reinharz, research professor in the Department of Social and Preventive Medicine at Université Laval, and his research team are developing a simulator to evaluate and compare the economic performance of various models that could contribute to the prevention of fractures caused by osteoporosis.

The simulator has created a virtual population of women over 40 to allow the researchers to evaluate the risk of fractures following preventive measures such as physical exercise, the use of calcium and vitamin D supplements, and screening of women at risk.

The simulator then estimates the costs linked to events occurring in the lives of these women, their lifespan and the number of fractures. The data produced by the simulator provide a means of comparing the preventive models and determining the cost and efficiency of each one. The results of the research will be available in 2010.

Several Québec public health organizations, already interested in the potential of this new evaluation tool, are hoping to use it in other prevention fields.