Safe and Effective Medications

A range of safe, effective, and affordable medications can reduce fracture risk by up to 70%. Policymakers must prioritize patient access and address barriers to ensure better long-term health outcomes.

A number of highly effective, safe, and inexpensive medications have been shown to reduce future fracture risk by 30% to 70%, dependent on the agent used and site of fracture. The following medications are available for managing osteoporosis in New Zealand, each suited to different patient needs and preferences:

• Alendronate and Risedronate: Oral bisphosphonates taken weekly, these are first-line treatments that significantly reduce the risk of vertebral, hip, and other fractures.
• Zoledronate: An intravenous bisphosphonate, favoured for its convenience with annual or 18-monthly infusions. However, infusion fees in some regions may pose barriers for some patients.
• Denosumab: A biannual subcutaneous injection, ideal for patients with renal impairment or those intolerant to bisphosphonates.
• Teriparatide: A daily injection that stimulates bone formation, used for severe osteoporosis in patients with multiple fractures.
• Raloxifene: A selective oestrogen receptor modulator (SERM) that reduces vertebral fracture risk in postmenopausal women.
• Hormone Replacement Therapy (HRT): Maintains bone density in postmenopausal women, especially effective within 10 years of menopause.

Policy makers should consider patient accessibility, potential barriers to treatment adherence, and regional disparities in service availability when evaluating osteoporosis management strategies. Comprehensive guidance for clinicians is available in the Guidance on the Diagnosis and Management of Osteoporosis in New Zealand.