Cost-benefit considerations for health policies: curative versus preventive treatment of osteoporosis

Abstract

From the 1990 decade, several paradigms of daily medical practice have been modified, favoring new, more efficient and effective medical approaches. The knowledge about osteoporosis underwent changes; it previously correlated the reduction of bone mass to an increased risk of fracture and directed the diagnosis only at elderly individuals. A later a model favors, since an early age, the simultaneous observation of the two bone matrices, the protein or real one and the inorganic or secondary one. The two models basically differ in terms of approach: one takes a curative approach, that diagnoses the signs and symptoms already installed of osteoporosis and adopts practices that follow the disease; the other, a preventive approach aiming at avoiding the installation of the disease. Thus, in order to evaluate the costs and benefits of curative against preventive approaches of osteoporosis in public health policies, a comparative study of patients treated in 2007-2009 on HCFMRP - USP was carried out. Data obtained were analyzed as for the costs incurred versus the benefits gained. The results of the study show that the preventive approach to osteoporosis, by means of bone micro-architecture screening, is economically viable. In this respect, in addition to providing economic evidence, the study analyzed the importance of applying a new paradigm regarding osteoporosis on the part of public healthcare policy in order to achieve better living conditions and well-being for the population.