1. Using decision analysis for your managed care formulary committee, compare the costs and outcomes over a one-year time period for preventive treatments for osteoporosis in postmenopausal women. Compare the following three drug options with the listed costs and outcomes:

Oral Cal-More given once a day as a 10 mg tablet at a cost of $650 per year 5% of patients have a fracture; 5% of patient have GI complications

Nasal Cal-More given once a day as a nasal spray providing 200 units at a cost of $875 per year 10% of patients have a fracture; 15% of patient have nasal irritation or bleeding

Oral Cal- More given once a week as a 70 mg tablet at a cost of $1,150 per year 5% of patients have a fracture; 4% of patient have GI complications Through claims analysis, it was determined that a fracture has an average cost of $3,500. GI complications on average cost $210 per episode and Nasal irritation and bleeding are associated with $100 per episode in care expenditures.

C. Calculate the Incremental Cost Effectiveness Ratio (ICER) for the improved GI tolerance of Cal- More given weekly versus Cal-More given once a day. (3 points)