A Merck representative visits your office and tells you that Fosamax® (alendronate) will decrease the incidence of repeat hip fracture by 50% over 3 years. That excites you because you have 20 elderly women and 5 elderly men who already have fractured one hip in your practice. You locate the study by Black in Lancet (1996) and find out that fracture occurs in 2.2% of placebo patients and 1.1% of patients on alendronate (Fosamax®).
Calculate the NNT. Do not worry about a negative or minus sign result. Example: 1.1-2.2 = 1.1 and not -1.1 when calculating the NNT.
Go to Epocrates Online and determine the cost of Fosamax®, based on one 70mg pill taken orally each week. (Keep in mind that generic Fosamax®, alendronate is now available, so calculate the COPE for both). Also, be aware that Fosamax is available in multiple doses for different routes. Show your actual calculation/math so we can tell what you did right versus wrong.
What does it cost to prevent one hip fracture over 3 years, using the COPE calculation posted in the chapter?
Is this more meaningful than just talking about a 50% reduction in hip fractures?
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