{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:36:31Z","timestamp":1780684591263,"version":"3.54.1"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aromatase inhibitors (AIs) significantly increase the risk of osteoporosis and related fractures in postmenopausal women with hormone receptor (HR)\u2013positive early breast cancer (EBC), posing a substantial clinical and economic burden. Effective fracture prevention strategies are critical, especially in resource\u2010constrained settings such as China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov microsimulation model was developed to evaluate the cost\u2010effectiveness of fracture prevention strategies for 60\u2010year\u2010old postmenopausal women with HR\u2010positive EBC treated with AIs in China. Six strategies were compared: (a) no intervention, (b) one\u2010time bone mineral density (BMD) screening followed by anti\u2010osteoporotic medication for patients with osteoporosis or osteopenia, (c) annual BMD screening followed by anti\u2010osteoporotic medication for patients with osteoporosis or osteopenia and (d) universal anti\u2010osteoporotic medication without prior BMD screening. Outcomes included incremental cost\u2010effectiveness ratios (ICERs) per quality\u2010adjusted life\u2010year (QALY) gained versus China's willingness\u2010to\u2010pay (WTP) threshold (3\u2009\u00d7\u2009GDP\/capita\u2009=\u2009$38\u2009223\/QALY).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All interventions reduced fractures but increased costs versus no intervention. For women aged 60\u201364\u2009years, one\u2010time BMD screening followed by therapy for osteoporosis (\n                      <jats:italic>T<\/jats:italic>\n                      \u2010score\u2009\u2264\u2009\u22122.5) achieved an ICER of $17\u2009368\/QALY, below the WTP threshold. Annual screening yielded marginally higher QALYs (+0.0096) but higher costs (+$895.09), resulting in an ICER exceeding $38\u2009223\/QALY. For women \u2265\u200965\u2009years, both one\u2010time screening for osteoporosis or osteopenia and universal therapy were cost\u2010effective. Universal therapy dominated in high\u2010risk subgroups (history of falls\/fractures), achieving the highest QALY gains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>One\u2010time BMD screening with selective alendronate for osteoporosis is cost\u2010effective for Chinese women aged \u2265\u200960 receiving AIs, aligning with China's healthcare constraints. Universal therapy becomes favourable for older or high\u2010risk subgroups. These data\u2010driven findings support tailored strategies to optimise bone health management and resource allocation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70161","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:36:54Z","timestamp":1765355814000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost\u2010Effectiveness of Fracture Prevention in Postmenopausal Women With Early Breast Cancer in China"],"prefix":"10.1002","volume":"16","author":[{"given":"Jin\u2010Yu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi\u2010Han","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College 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College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Mori","sequence":"additional","affiliation":[{"name":"Health Services Research and Development Center University of Tsukuba  Tsukuba Ibaraki Prefecture Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Moriwaki","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management, Department of Biomedical Science, College of Life Sciences Ritsumeikan University  Kusatsu Shiga Prefecture Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-4462","authenticated-orcid":false,"given":"Ru\u2010Xu","family":"You","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan 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