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In ageing populations, bone fractures and impaired quality of life caused by osteoporosis increasingly affect not only women, but also older men. Experts have been calling for widespread densitometry screening programmes for men aged 70 years and older with treatment with oral bisphosphonate as appropriate. These opinion based calls have largely been left unanswered, with screening programmes for men sparse and understudied.
A recent modelling study used data from large cohort studies, US national databases, and systematic reviews to better inform decisions on the cost effectiveness of screening men for osteoporosis. With costs of bisphosphonate at their current level, screening might be cost effective at the threshold of $50000 (£25000; €36000) for men aged 65 years with a previous self reported bone fracture, and for men aged 80 years or older without previous fracture.
It seems that universal screening of all men aged 70 years or older, as experts have suggested, would only be cost effective if society was willing to pay $100000 for a quality adjusted life year gained, or if the cost of oral bisphosphonate treatment became less than $500 per year. This might happen in the United States when alendronate loses patent protection in 2008.2008.