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.. If a patient with a T-score in full range of the osteopenic status (-1.0 Casein kinase 2 $5,177 per fracture prevented (or $22,813 and $11,116 per QALY gained) if therapy begins at 55 years and 60 years, respectively, and these values remain within the accepted willingness-to-pay threshold of the per capita GDP in Korea ($25,700). For older women who are aged 65 years, drug therapy remains a dominant option. When we anticipated a worst case scenario for treatment effectiveness with raloxifene (RR for vertebral fractures 0.88), the estimated ICERs were $20,627 and -$13,765 per QALY gained when therapy was initiated at 55 to 65 years of age. Similarly, a worst case scenario for risedronate therapy (RR for vertebral or non-vertebral fractures 0.44) showed that the estimated ICERs were $22,535 and -$13,075 per QALY gained when therapy was initiated at 55 to 65 years of age. Another parameter that had a strong impact was compliance with medication. When we applied compliance with medication that was less than 100%, the ICERs decreased or became negative. This was mainly caused by the reduction in the cost of the intervention resulted from a low rate of medication intake. While the lower ICERs appeared to represent improvements in the cost-effectiveness of the medications, the numbers of fractures prevented decreased to 19.2, 24.9, and 31.5 fractures per 1,000 women who began treatment for osteopenia at 55, 60, and 65 years of age, respectively, which represents a 70% reduction in fracture Selleckchem Trichostatin A prevention compared with the cases who were 100% compliant. When we assumed a worst case scenario with respect to the risk reduction for BC (RR 0.83) that is associated with taking raloxifene, the ICER remained within the accepted willingness-to-pay threshold of the per capita GDP at all ages. Similarly, a worst case scenario in relation to the risk increase for VTE (RR 25.5) that is associated with raloxifene therapy did not change the cost-effectiveness status of our study's results. Given the assumed variance, all of the parameters used in the sensitivity analysis had ICERs were less than the GDP per capita. This convinced us that the estimated cost-effectiveness Vismodegib order of medical intervention to prevent osteoporosis and fractures in osteopenic patients is robust. DISCUSSION This study examined the cost-effectiveness of drug therapy with raloxifene or risedronate compared with no therapy in Korean postmenopausal women who had osteopenia. While evidence has accumulated that supports the economic outcomes of drug therapy administered to patients with osteoporosis, there is limited evidence that describes the cost-effectiveness of drug therapy for elderly women with osteopenia.[19,35,36,37,38] Thus, the results from our study add to the empirical evidence that is guiding the selection of treatment strategies for individuals with osteopenia.