OBJECTIVE: To assess the cost effectiveness of nasal calcitonin (Miacalcin) compared with no therapy, @entity561 or @entity10210 in the treatment of postmenopausal @entity1 with previous @entity3604 . DESIGN AND SETTING: Meta-analysis followed by economic analysis. PERSPECTIVE: A Canadian provincial Ministry of Health. METHODS: The meta-analysis of randomised controlled clinical trials was based on the recommendations of the Cochrane Collaboration. Economic analysis was conducted within a Markov model using probabilities and costs derived from Canadian sources. RESULTS: The meta-analysis found evidence of the positive effect of both nasal @entity175 and @entity561 in reducing the risks of hip, wrist and @entity174 in postmenopausal @entity1 . However, there was a lack of evidence of the effect of @entity10210 on hip and wrist @entity174 . For a 65-year-old @entity1 , with 5 years' therapy, the incremental cost per quality-adjusted life-year (QALY) gained for nasal calcitonin was 46,500 Canadian dollars ( Can) compared with no therapy and  Can32,600 compared with @entity10210 (1998 values). Comparison with @entity561 was highly sensitive to the inclusion of one specific trial. CONCLUSIONS: Given the results of the analysis, based on current evidence, nasal calcitonin can be considered at the margins of being cost effective when compared with no therapy. Compared with active therapy, nasal calcitonin can be considered more cost effective than @entity10210 , but its cost effectiveness versus @entity561 is inconclusive.

Cost effectiveness of nasal calcitonin in postmenopausal XXXX : use of Cochrane Collaboration methods for meta-analysis within economic evaluation.

@entity1 :: ('9606', 'Species') :: ['women', 'woman'] @entity3604 :: ('MESH:D058866', 'Disease') :: ['osteoporotic fracture'] @entity175 :: ('MESH:D002116', 'Chemical') :: ['calcitonin'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'vertebral fractures'] @entity561 :: ('MESH:D019386', 'Chemical') :: ['alendronate'] @entity10210 :: ('MESH:D012968', 'Chemical') :: ['etidronate']
@entity1 :: (9606,Species) :: ['women']
