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. 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 Fosamax®. Now:

What % is the Experimental Event Rate (EER)?

What % is the Control Event Rate (CER)?

What is the Absolute Risk Reduction (ARR)?

Calculate the NNT. Use 100 as the numerator. Do not worry about a negative or minus sign result. Example: 1.1-2.2 = 1.1 and not -1.1 when calculating NNT.

Go to Epocrates Online (**if you are unable to find costs at this site, you can use another site, for example, Walgreens, but you must indicate which site and cite and reference the website in your answer), and determine the cost of Fosamax®, andalendronate, the generic for Fosamax®,

The dosage for both of these is one 70mg pill taken orally once a week. 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.

With the NNT and cost of Fosamax and alendronate you have calculated above, use the Cost of Preventing Event (COPE) (pg 331 in textbook), calculation to determine what it costs to prevent one hip fracture over 3 years. Do this for both Fosamax and for alendronate.

What does the COPE calculation tell you?

Which drug would you be more likely to prescribe and why

Is this more meaningful than just talking about a 50% reduction in hip fractures?