{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:59:07Z","timestamp":1765727947112,"version":"3.48.0"},"reference-count":39,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,7,24]]},"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness of routine administration of single-dose zoledronic acid for nursing home residents with osteoporosis in the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Markov cohort simulation model based on published literature from a healthcare sector perspective over a lifetime horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nursing homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A hypothetical cohort of nursing home residents aged 85 years with osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Two strategies were compared: (1) a single intravenous dose of zoledronic acid 5\u2009mg and (2) usual care (supplementation of calcium and vitamin D only).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Incremental cost-effectiveness ratio (ICER), as measured by cost per quality-adjusted life year (QALY) gained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with usual care, zoledronic acid had an ICER of $207\u2009400 per QALY gained and was not cost-effective at a conventional willingness-to-pay threshold of $100\u2009000 per QALY gained. The results were robust to a reasonable range of assumptions about incidence, mortality, quality-of-life effects and the cost of hip fracture and the cost of zoledronic acid. Zoledronic acid had a potential to become cost-effective if a fracture risk reduction with zoledronic acid was higher than 23% or if 6-month mortality in nursing home residents was lower than 16%. Probabilistic sensitivity analysis showed that the zoledronic acid would be cost-effective in 14%, 27% and 44% of simulations at willingness-to-pay thresholds of $50 000, $100\u2009000 or $200\u2009000 per QALY gained, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine administration of single-dose zoledronic acid in nursing home residents with osteoporosis is not a cost-effective use of resources in the USA but could be justifiable in those with a favourable life expectancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-022585","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T08:07:32Z","timestamp":1536048452000},"page":"e022585","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Cost-effectiveness of single-dose zoledronic acid for nursing home residents with osteoporosis in the USA"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5114-3368","authenticated-orcid":false,"given":"Kouta","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Medicine, Hebrew SeniorLife, Roslindale, Massachusetts, USA"},{"name":"Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"2025121407533351000_8.9.e022585.1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glw034"},{"key":"2025121407533351000_8.9.e022585.2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1093\/gerona\/glp019","article-title":"Survival of aged nursing home residents with hip fracture","volume":"64A","author":"Berry","year":"2009","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025121407533351000_8.9.e022585.3","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1001\/jamainternmed.2014.2362","article-title":"Survival and functional outcomes after hip fracture among nursing home residents","volume":"174","author":"Neuman","year":"2014","journal-title":"JAMA Intern Med"},{"key":"2025121407533351000_8.9.e022585.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2012.04033.x"},{"key":"2025121407533351000_8.9.e022585.5","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.13.1502"},{"key":"2025121407533351000_8.9.e022585.6","doi-asserted-by":"publisher","DOI":"10.1007\/s001980070055"},{"key":"2025121407533351000_8.9.e022585.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.8.972"},{"key":"2025121407533351000_8.9.e022585.8","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050129"},{"key":"2025121407533351000_8.9.e022585.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2007.04.002"},{"key":"2025121407533351000_8.9.e022585.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02119.x"},{"key":"2025121407533351000_8.9.e022585.11","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.bone.2011.02.006","article-title":"Correlations of nursing home characteristics with prescription of osteoporosis medications","volume":"48","author":"Parikh","year":"2011","journal-title":"Bone"},{"key":"2025121407533351000_8.9.e022585.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0009515","article-title":"A scoping review of strategies for the prevention of hip fracture in elderly nursing home residents","volume":"5","author":"Sawka","year":"2010","journal-title":"PLoS One"},{"key":"2025121407533351000_8.9.e022585.13","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1001\/jamainternmed.2015.0747","article-title":"Efficacy and safety of single-dose zoledronic acid for osteoporosis in frail elderly women: a randomized clinical trial","volume":"175","author":"Greenspan","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2025121407533351000_8.9.e022585.14","unstructured":"U.S. Department of Health and Human Services. 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