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Intervention thresholds for osteoporosis in the UK

Kanis, JA ; Borgsrom, F ; Zethraeus, N ; Johnell, Olof LU ; Oden, A and Jonsson, B (2005) In Bone 36(1). p.22-32
Abstract
The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in women based on data from the UK. We modelled the effects of an intervention costing pound350 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect (offset time) for a further 5 years. Sensitivity analyses included a range of treatment duration (3-10 years), intervention costs (pound300-400/year) and offset times (0-15 years). Data on costs and risks were from the UK. Costs included direct costs, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of pound30,000/QALY gained was used. With the base case (pound350 per year; 35%... (More)
The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in women based on data from the UK. We modelled the effects of an intervention costing pound350 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect (offset time) for a further 5 years. Sensitivity analyses included a range of treatment duration (3-10 years), intervention costs (pound300-400/year) and offset times (0-15 years). Data on costs and risks were from the UK. Costs included direct costs, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of pound30,000/QALY gained was used. With the base case (pound350 per year; 35% efficacy) treatment in women was cost-effective with a 10-year hip fracture probability that ranged from 1.1% at the age of 50 years to 9.0% at the age of 85 years. Intervention thresholds were sensitive to the assumed costs and offset time. 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. Cost-effective scenarios were found for women at the threshold for osteoporosis from the age of 60 years. Treatment of established osteoporosis was cost-effective irrespective of age. 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 from the UK at moderately increased fracture risk. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
threshold, intervention, cost-effectiveness, hip fracture, osteoporotic fracture
in
Bone
volume
36
issue
1
pages
22 - 32
publisher
Elsevier
external identifiers
  • pmid:15663999
  • wos:000226733500004
  • scopus:12344310388
  • pmid:15663999
ISSN
1873-2763
DOI
10.1016/j.bone.2004.08.018
language
English
LU publication?
yes
id
784e955b-4695-476c-ac18-782ffc8d44b8 (old id 897531)
date added to LUP
2016-04-01 16:52:12
date last changed
2022-02-05 19:09:33
@article{784e955b-4695-476c-ac18-782ffc8d44b8,
  abstract     = {{The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in women based on data from the UK. We modelled the effects of an intervention costing pound350 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect (offset time) for a further 5 years. Sensitivity analyses included a range of treatment duration (3-10 years), intervention costs (pound300-400/year) and offset times (0-15 years). Data on costs and risks were from the UK. Costs included direct costs, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of pound30,000/QALY gained was used. With the base case (pound350 per year; 35% efficacy) treatment in women was cost-effective with a 10-year hip fracture probability that ranged from 1.1% at the age of 50 years to 9.0% at the age of 85 years. Intervention thresholds were sensitive to the assumed costs and offset time. 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. Cost-effective scenarios were found for women at the threshold for osteoporosis from the age of 60 years. Treatment of established osteoporosis was cost-effective irrespective of age. 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 from the UK at moderately increased fracture risk.}},
  author       = {{Kanis, JA and Borgsrom, F and Zethraeus, N and Johnell, Olof and Oden, A and Jonsson, B}},
  issn         = {{1873-2763}},
  keywords     = {{threshold; intervention; cost-effectiveness; hip fracture; osteoporotic fracture}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{22--32}},
  publisher    = {{Elsevier}},
  series       = {{Bone}},
  title        = {{Intervention thresholds for osteoporosis in the UK}},
  url          = {{http://dx.doi.org/10.1016/j.bone.2004.08.018}},
  doi          = {{10.1016/j.bone.2004.08.018}},
  volume       = {{36}},
  year         = {{2005}},
}