Nayak S, et al. - A cost-effectiveness analysis was conducted to compare 5 vs 10 years of alendronate treatment prior to a 5-year drug holiday for postmenopausal osteoporotic women. An individual-level state-transition microsimulation model was designed to match 3 treatment strategies for US postmenopausal women with osteoporosis and femoral neck BMD T-scores between − 2.5 and − 3.5 at baseline: recurrent periods of 5 years of alendronate followed by 5 years of drug holiday (alendronate 5/5), recurrent periods of 10 years of alendronate followed by 5 years of drug holiday (alendronate 10/5), and no alendronate treatment. The results displayed that younger postmenopausal women (ages 50–70) with osteoporosis would likely help from a drug holiday, whereas older women (age 80) are likely to benefit from treatment for 10 years before a drug holiday after 5 years of alendronate treatment.