The recent National Institute for Health and Care Excellence (NICE) updated multiple technology appraisal on bisphosphonate use in osteoporosis¹ demonstrates how, for a common disorder, the strict application of cost-effectiveness thresholds for inexpensive drugs might lead to counterintuitive and potentially harmful guidance. The multiple technology appraisal incorporates the development of fracture risk calculators based on individualised clinical risk factors, such as FRAX and QFracture (recommended by NICE for the assessment of fracture risk in some sections of the population²), and the availability of low-cost generic forms of oral and intravenous bisphosphonates.

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骨质疏松症中的双膦酸盐：NICE容易吗？

美国国立卫生研究院（NICE）最近更新了有关骨质疏松症中双膦酸盐使用的多项技术评估^1，证明了对于常见疾病，严格应用廉价药物的成本效益阈值可能会导致违反直觉和潜在有害指导的情况。多种技术评估结合了基于个性化临床风险因素（例如FRAX和QFracture）的骨折风险计算器的开发（FRICE和QFracture（NICE建议在人群中某些部分评估骨折风险²），以及低成本仿制药的可用性形式的口服和静脉注射双膦酸盐。