Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden.
Journal article, 2005

The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in men and women, based on data from Sweden. We modeled the effects of a treatment costing $500 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect for a further 5 years. Sensitivity analyses included a range of effectiveness (10-50%) and a range of intervention costs ($200-500/year). Data on costs and risks were from Sweden. Costs included direct costs, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of approximately $45,000/QALY gained was used. Cost of added years was included in a sensitivity analysis. With the base case ($500 per year; 35% efficacy) treatment in women was cost-effective with a 10-year hip fracture probability that ranged from 1.2% at the age of 50 years to 7.4% at the age of 80 years. Similar results were observed in men except that the threshold for cost-effectiveness was higher at younger ages than in women (2.0 vs 1.2%, respectively, at the age of 50 years). Intervention thresholds were sensitive to the assumed effectiveness and intervention cost. The exclusion of osteoporotic fractures other than hip fracture significantly increased the cost-effectiveness ratio because of the substantial morbidity from such other fractures, particularly at younger ages. We conclude that the inclusion of all osteoporotic fractures has a marked effect on intervention thresholds, that these vary with age, and that available treatments can be targeted cost-effectively to individuals at moderately increased fracture risk.

Age Factors

80 and over

methods

Cost-Benefit Analysis

Aged

Aged

Humans

epidemiology

Markov Chains

Female

Bone

Fractures

economics

prevention & control

Sex Factors

epidemiology

Male

Risk Factors

Osteoporosis

Middle Aged

prevention & control

Sweden

Hip Fractures

drug therapy

epidemiology

economics

Author

John A Kanis

Olof Johnell

Anders Odén

University of Gothenburg

Chalmers, Mathematical Sciences, Mathematical Statistics

Frederik Borgstrom

Helena Johansson

University of Gothenburg

Chris De Laet

Bengt Jönsson

Osteoporosis International

0937-941X (ISSN) 1433-2965 (eISSN)

Vol. 16 1 6-14

Subject Categories

Endocrinology and Diabetes

Physiology

DOI

10.1007/s00198-004-1623-4

PubMed

15103452

More information

Created

10/6/2017