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The Pharmacoeconomics of Hormone Replacement Therapy

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Author Info

  • David J Torgerson

    (Centre for Health Economics and Department of Health Studies, University of York, York, England)

  • David M Reid

    (Department of Medicine and Therapeutics, University of Aberdeen, Foresterhill Medical School, Aberdeen, Scotland)

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    Abstract

    Hormone replacement therapy (HRT) is a highly cost-effective treatment for symptoms of the menopause such as hot flushes (flashes). A number of economic evaluations have indicated that it may also be a cost-effective therapy for the prevention of cardiovascular disease and osteoporosis. However, these evaluations are based on the premise that HRT will reduce cardiovascular disease by 30 to 50%. Recent evidence casts doubt on its effectiveness at preventing cardiovascular disease, certainly as a secondary preventive therapy. Furthermore, HRT is likely to increase the incidence of breast cancer. If the effect of HRT on the cardiovascular system is slight or nonexistent, but its effect on breast cancer is modest or strong, then HRT is unlikely to be a cost-effective treatment for asymptomatic women at low risk of osteoporosis. However, the unwanted effects of HRT on the breast may be significantly reduced by targeting therapy to those women with low bone mass and who have other risk factors for fracture. Such a strategy is likely to be more cost effective than a strategy which allows asymptomatic women with low fracture risk to take HRT in the long term. As selective estrogen receptor modulators (SERMs) aggravate menopausal symptoms they are not likely to be an alternative for most perimenopausal women. Therefore, SERMs are more likely to be a competitor to existing and forthcoming bisphosphonates rather than HRT.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 16 (1999)
    Issue (Month): 1 ()
    Pages: 9-16
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:16:y:1999:i:1:p:9-16

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Reviews-on-treatment; Pharmacoeconomics; Hormonal-replacements; Menopausal-syndrome; Cost-analysis; Quality-of-life; Postmenopausal-osteoporosis; Cardiovascular-disorders;

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