Intervention thresholds for osteoporosis
(2002) In Bone 31(1). p.26-31- Abstract
- The aim of this study was to determine the threshold of fracture probability at which interventions become cost-effective. We modeled the effects of a treatment costing $500/year, given for 5 years, that decreased the risk of all osteoporotic fractures by 35%, followed by a waning of effect for 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 and costs in added years of life, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of $60,000 per quality-adjusted life-year (QALY) gained was used. Costs of added years were excluded in a sensitivity analysis for which a... (More)
- The aim of this study was to determine the threshold of fracture probability at which interventions become cost-effective. We modeled the effects of a treatment costing $500/year, given for 5 years, that decreased the risk of all osteoporotic fractures by 35%, followed by a waning of effect for 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 and costs in added years of life, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of $60,000 per quality-adjusted life-year (QALY) gained was used. Costs of added years were excluded in a sensitivity analysis for which a threshold value of $30,000 per QALY was used. In the base case, intervention was cost-effective when treatment was targeted to women at average risk at age of greater than or equal to65 years. Irrespective of the efficacy modeled (10%-50%) or of cost of intervention ($200-500/year) segments of the population at average risk could be targeted cost-effectively: The lower the intervention cost and the higher the effectiveness, the lower the age at which intervention was cost-effective. With the base case ($500/year; 35% efficacy) treatment in women was cost-effective with a 10 year hip fracture probability that ranged from 1.4% at the age of 50 years to 4.4% at the age of 65 years. The exclusion of osteoporotic fractures other than hip fracture would increase the threshold to a 9%-11% 10 year probability because of the substantial morbidity from fractures other than hip fracture, 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 cost-effectively targeted to individuals at moderately increased risk. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/892926
- author
- Kanis, JA ; Johnell, Olof LU ; Oden, A ; De Laet, C ; Oglesby, A and Jonsson, B
- organization
- publishing date
- 2002
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- osteoporotic fracture, cost of added years, threshold, cost-effectiveness, intervention, hip fracture
- in
- Bone
- volume
- 31
- issue
- 1
- pages
- 26 - 31
- publisher
- Elsevier
- external identifiers
-
- wos:000177036000005
- pmid:12110408
- scopus:0036317374
- ISSN
- 1873-2763
- DOI
- 10.1016/S8756-3282(02)00813-X
- language
- English
- LU publication?
- yes
- id
- 4160b8d9-a648-4d02-b8be-8396fe63a6b9 (old id 892926)
- date added to LUP
- 2016-04-01 15:33:35
- date last changed
- 2022-01-28 05:54:37
@article{4160b8d9-a648-4d02-b8be-8396fe63a6b9,
abstract = {{The aim of this study was to determine the threshold of fracture probability at which interventions become cost-effective. We modeled the effects of a treatment costing $500/year, given for 5 years, that decreased the risk of all osteoporotic fractures by 35%, followed by a waning of effect for 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 and costs in added years of life, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of $60,000 per quality-adjusted life-year (QALY) gained was used. Costs of added years were excluded in a sensitivity analysis for which a threshold value of $30,000 per QALY was used. In the base case, intervention was cost-effective when treatment was targeted to women at average risk at age of greater than or equal to65 years. Irrespective of the efficacy modeled (10%-50%) or of cost of intervention ($200-500/year) segments of the population at average risk could be targeted cost-effectively: The lower the intervention cost and the higher the effectiveness, the lower the age at which intervention was cost-effective. With the base case ($500/year; 35% efficacy) treatment in women was cost-effective with a 10 year hip fracture probability that ranged from 1.4% at the age of 50 years to 4.4% at the age of 65 years. The exclusion of osteoporotic fractures other than hip fracture would increase the threshold to a 9%-11% 10 year probability because of the substantial morbidity from fractures other than hip fracture, 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 cost-effectively targeted to individuals at moderately increased risk.}},
author = {{Kanis, JA and Johnell, Olof and Oden, A and De Laet, C and Oglesby, A and Jonsson, B}},
issn = {{1873-2763}},
keywords = {{osteoporotic fracture; cost of added years; threshold; cost-effectiveness; intervention; hip fracture}},
language = {{eng}},
number = {{1}},
pages = {{26--31}},
publisher = {{Elsevier}},
series = {{Bone}},
title = {{Intervention thresholds for osteoporosis}},
url = {{http://dx.doi.org/10.1016/S8756-3282(02)00813-X}},
doi = {{10.1016/S8756-3282(02)00813-X}},
volume = {{31}},
year = {{2002}},
}