No abstract

This disease-modeling approach generates detailed information on the current and future cost burden of osteoporosis for an individual state population. Predictions based on this methodology may enable health-policy decisions that are tailored to local needs.

Vertebral fractures are more expensive and resource-intensive than previously reported. Furthermore, total costs may be much greater when the components of post-acute care are fully captured.

AimTo assess the influence of ketoconazole on azimilide pharmacokinetics. MethodsA two-period randomized crossover study was conducted in healthy male and female subjects (19-45 years). Placebo or 200 mg ketoconazole were administered orally every 24 h for 29 days. On day 8, a single oral dose of 125 mg azimilide dihydrochloride was coadministered following an overnight fast. Blood samples were obtained prior to and for 22 days following azimilide dihydrochloride administration. The plasma protein binding of azimilide was also assessed at 6 h after dosing. ResultsFollowing ketoconazole administration, a 16% increase in azimilide AUC (90% confidence interval (CI) 112%, 120%), a 12% increase in C max (95% CI 107%, 116%), a 13% increase in t 1/2,z (95% CI 107%, 120%) and a 14% decrease in CL o (95% CI 82%, 90%) were observed. ConclusionsThe changes in azimilide pharmacokinetics following ketoconazole treatment are not clinically important since the 90% CI for the AUC fell within the prespecified range of 80-125%. Thus, no clinically important drug interactions are expected when azimilide dihydrochloride is coadministered with CYP3A4 inhibitors.

BACKGROUND: The UK has more than 19 million people aged over 50, including about 9.4 million aged over 65. Demographic changes will lead to increases in the over‐50 population of 10% and 25% by 2010 and 2020, respectively. There are already 3 million UK residents with osteoporosis, but the prevalence of osteoporosis increases with age, and the public health impact of osteoporosis will increase substantially over the next 20 years. OBJECTIVE: To predict fracture numbers and corresponding costs for men and women aged 50–99 years in the UK for the years 2000 to 2020. METHODS: A Markov model was designed to simulate the natural history of osteoporosis within the UK population. Inputs to the model included age/sex specific fracture incidence rates, published unit costs for different fracture types (hip, vertebral, forearm/wrist, other), age/sex specific mortality rates, and age/sex specific population totals. Total fracture numbers were adjusted using published site‐specific attribution figures to identify the number that were a consequence of osteoporosis. Iteration techniques were employed across ages 50–99 in men and women, to generate the distribution of prevalence‐based estimates of fractures and costs for the base year 2000. Osteoporosis costs and fracture numbers were then projected into future years by applying growth rates in age/sex specific population totals to these year 2000 estimates. RESULTS: In 2000 there were 190,000 osteoporosis‐related fractures at a cost of £1.8 billion. Men accounted for 32,000 fractures and £330 million. By 2020, annual osteoporotic fracture numbers increased by over 21% to 230,000, with costs growing by 20% to over £2.1 billion. Cumulative totals for 2000–2010 were 2.2 million fractures and £20.3 billion. CONCLUSIONS: Osteoporotic fractures will have substantial and increasing impacts on UK health services unless highly effective preventative interventions achieve widespread use.