Osteoporosis is a chronic disease with serious socioeconomic impact worldwide because of its huge prevalence, and enormous costs associated with treatment of this condition and its consequences, i.e. fractures. To perform pharmacoeconomic analysis with the aim to evaluate and compare all available treatments for osteoporosis, in order to optimize the efficiency of osteoporosis treatments and therewith management of this serious healthcare problem. A retrospective, modeled pharmacoeconomic analysis of different treatment regimens for osteoporosis was performed from the widest, societal perspective. Analyses included postmenopausal women divided in four age groupsČ 50-64 years, 65-74 years, 75-84 years, and over 85 years, respectively. The following seven treatment options were analyzedČ no drug therapy, alendronate, etidronate, risedronate, calcitonin, hormone replacementtherapy, and raloxifene. Data on clinical efficacy of osteoporotic regimens were pooled from published meta-analyses and randomized controlled trials. Economic analysis was performed on the basis of a Markov model developed with using data on probabilities and costs derived from Slovenian sources. Results of our cost-effectiveness and cost-utility analysis suggest that hormone replacement therapy is the most cost-effective treatment option for women in the age group 50-64č alendronate and hormone replacement therapy are best options for treating women aged 65-74č with the increasing age, even more expensive treatments such as calcitonin and risedronate are cost-effective and justified besides alendronate and hormone replacement therapy. However, raloxifene and etidronate failed to be cost-effective in ouranalysis in all scenarios. Cost-benefit analysis results suggest that population-wide therapy with both hormone replacement therapy and raloxifene will result with a negative B-C ratio, i.e. with extra costs instead of beneficial savings to society. Results of our cost-minimization analysis indicate approximately SIT 100 million per year savings by switching to generic alendronate therapy in Slovenia. Given the results of our cost-effectiveness analysis, hormone replacement therapy, alendronate, risedronate, and calcitonin can be considered as cost-effective treatments forprevention of fractures in women with postmenopausal osteoporosis.