Cost-effectiveness analysis of fracture liaison services: a Markov model using Dutch real-world data.
Osteoporos Int
; 35(2): 293-307, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37783759
ABSTRACT
This study assessed the lifetime cost-effectiveness of a fracture liaison service (FLS) compared to no-FLS in the Netherlands from a societal perspective and suggested that FLS was cost-effective in patients with a recent fracture aged 50 years and older. The implementation of FLS could lead to lifetime health-economic benefits. INTRODUCTION:
The objective of this study was to investigate the lifetime cost-effectiveness of a fracture liaison service (FLS) compared to no-FLS in the Netherlands from a societal perspective and using real-world data.METHODS:
Annual fracture incidence, treatment scenarios as well as treatment initiation in the years 2017-2019 were collected from a large secondary care hospital in the Netherlands. An individual-level, state transition model was designed to simulate lifetime costs and quality-adjusted life years (QALYs). Treatment pathways were differentiated by gender, presence of osteoporosis and/or prevalent vertebral fracture, and treatment status. Results were presented as incremental cost-effectiveness ratios (ICER). Both one-way and probabilistic sensitivity analyses were conducted.RESULTS:
For patients with a recent fracture aged 50 years and older, the presence of an FLS was associated with a lifetime 45 higher cost and 0.11 additional QALY gained leading to an ICER of 409 per QALY gained, indicating FLS was cost-effective compared to no-FLS at the Dutch threshold of 20,000/QALY. The FLS remained cost-effectiveness across different age categories. Our findings were robust in all one-way sensitivity analyses, the higher the treatment initiation rate in FLS, the greater the cost-effective of FLS. Probabilistic sensitivity analyses revealed that FLS was cost-effective in 90% of the simulations at the threshold of 20,000/QALY, with women 92% versus men 84% by gender.CONCLUSION:
This study provides the first health-economic analysis of FLS in the Netherlands, suggesting the implementation of FLS could lead to lifetime health-economic benefits.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteoporose
/
Fraturas por Osteoporose
Tipo de estudo:
Evaluation_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Osteoporos Int
Assunto da revista:
METABOLISMO
/
ORTOPEDIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Holanda