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Despite widespread availability and use of oral bisphosphonates, fracture rates and associated medical costs are still high. Differences in fracture risk among these agents, if any, have not been quantified due to the lack of high-quality, head-to-head, randomized, controlled trials assessing this outcome. Randomized, placebo-controlled trials have shown that alendronate and risedronate reduce rates of both vertebral and nonvertebral fractures, whereas only reduction in vertebral fractures has been found for ibandronate.

journal of managed care pharmacy

Analysis of the Comparative Effectiveness of 3 Oral Bisphosphonates in a Large Managed Care Organization: Adherence, Fracture Rates, and All-Cause Cost