Two parallel cost-effectiveness studies comparing oral ibandronate and i.v. zoledronic acid and generic pamidronate have been performed. Two global economic models were adapted to the Italian National Health Service within the management of metastatic osteolysis in breast cancer patients undergoing chemotherapy and hormonal therapy. Total cost was respectively Euro 100 and Euro 418 lower per patient for ibandronate, vs. zoledronic acid and pamidronate in chemotherapy-treated patients, and Euro 337 and Euro 419 lower in patients undergoing hormonal therapy; also, with a small increment in QALYs, ibandronate resulted as the dominant therapeutic option.