Patients in a fracture state can stay in the same fracture state if they re-fracture, change to another fracture state, die or change in the next cycle to the post-fracture state. Because hip fracture is

associated with extra costs in the year following the fracture that are greater than the hospitalization cost of any other fractures, patients who have had a hip fracture were only at risk for another hip fracture or dying in the first cycle following the fracture. Patients being in any post-fracture state might have a new fracture (all fracture types are possible), die or move to the 4-Hydroxytamoxifen cost ‘no fracture’ state. The probability for patients to move to the VTE health state was also considered under treatment with strontium ranelate. Fracture data A description of the different components of the model is provided below. Model data are included in Table 1. Readers are also referred to previously published research for further details and limitations of the model [17]. Table 1 Model data Parameter Data Distribution Incidence (annual rate per 1000) of fracture Hip 0.84 (60–64 y), 1.18 (65–69 y), 1.87 (70–74 y), 3.97 (75–79 y), 8.50 (80–84 y), 17.18 (85–89 y), 25.21 (90–94 y), 36.63 (95+ y) Beta Vertebral GSK2118436 2.68 (60–64 y), 1.41 (65–69 y), 3.13 (70–74 y), 3.92 (75–79 y), 5.22 (80–84 y), 12.13 (85–89 y),

17.80 (90–94 y), 25.87 (95+ y) Normal Wrist 1.66 (60–64 y), 1.64 (65–69 y), 0.56 (70–74 y), 1.11 (75–79 y), 1.45 (80–84 y), 3.28 (85–89 y), 4.81 (90–94 y), 7.00 (95+ y) Normal Other 3.14 (60–64 y), 4.33 (65–69 y), 4.80 (70–74 y), 4.82 (75–79 y), 17.87 (80–84 y), 24.62 (85–89 y), 36.11 (90–94 y), 52.50 (95+ y) Normal Excess mortality % of excess mortality attributable to fracture 25 % Normal 0–6 months 5.75 Log-normal 6–12 months 2.31 Log-normal Subs y. 1.69 Log-normal Direct fracture costs (€2010) Hip, first 6 months From 9,872 to 12,198 Normal

Hip, extra costs in the year following the fracture 8,001 Normal Hip, yearly long-term costs From 1,705 to 13,918 Normal CV, first 6 months From 2,413 to 2,817 Normal Wrist, first 6 months Florfenicol From 2,009 to 2,346 Normal Other, first 6 months From 2,401 to 2,812 Normal Health state utility values General population 0.84 (60–69 y), 0.78 (70–79 y), 0.71 (+80 y)   Hip (first y/subs y) 0.80/0.90 Beta CV (first y/subs y) 0.72/0.93 Beta Wrist (first y/subs y) 0.94/1.00 Beta Other (first y/subs y) 0.91/1.00 Beta For normal distributions, a standard Fulvestrant deviation of 15 % of the mean was assumed. Parameters of other distributions were derived from the 95 % confidence intervals CV clinical vertebral, Subs subsequent, Y years The incidence of hip fractures in the general men population was derived from the national database of hospital bills (average of the years 2005–2007) [2].