Cost-effectiveness of a multicomponent-adherence intervention in fracture liaison services.
Expert Rev Pharmacoecon Outcomes Res
; 24(8): 987-996, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-38860294
ABSTRACT
BACKGROUND:
This study aims to assess the lifetime cost-effectiveness of a multi-component adherence intervention (MCAI), including a patient decision aid and motivational interviewing, compared to usual care in patients with a recent fracture attending fracture liaison services (FLS) and eligible for anti-osteoporosis medication (AOM). RESEARCH DESIGN ANDMETHODS:
Data on AOM initiation and one-year persistence were collected from a quasi-experimental study conducted between 2019 and 2023 in two Dutch FLS centers. An individual level, state-transition Markov model was used to simulate lifetime costs and quality-adjusted life years (QALYs) with a societal perspective of MCAI vs usual care. One-way and probabilistic sensitivity analyses were conducted including variation in additional FLS and MCAI costs (no MCAI cost in baseline).RESULTS:
MCAI was associated with gain in QALYs (0.0012) and reduction in costs (-16) and is therefore dominant. At the Dutch willingness-to-pay threshold of 50,000/QALY, MCAI remained cost-effective when increasing costs of the FLS visit or the yearly maintenance cost for MCAI up to +60. Probabilistic sensitivity analysis demonstrated MCAI to be dominant in 54% of the simulations and cost-effective in 87% with a threshold of 50,000/QALY.CONCLUSIONS:
A MCAI implemented in FLS centers may lead to cost-effective allocation of resources in FLS care, depending on extra costs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cadeias de Markov
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Análise Custo-Benefício
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Anos de Vida Ajustados por Qualidade de Vida
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Conservadores da Densidade Óssea
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Adesão à Medicação
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Entrevista Motivacional
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article