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A health economic simulation model for the clinical management of osteoporosis

Jonsson, E.; Hansson-Hedblom, A.; Ljunggren, Östen; Åkesson, K. LU ; Spångeus, A.; Kanis, J. A. and Borgström, F. (2017) In Osteoporosis International
Abstract

Summary: The objective was to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Results showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. Introduction: The purpose of this study is to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Methods: The analysis was carried out using a model that simulates the individual patients... (More)

Summary: The objective was to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Results showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. Introduction: The purpose of this study is to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Methods: The analysis was carried out using a model that simulates the individual patients considered for pharmacological treatment during 1 year and their projected osteoporosis treatment pathway, quality-adjusted life years (QALYs) and costs over their remaining lifetime. All patients regardless of treatment or no treatment were simulated. Information on current management of osteoporosis in terms of patient characteristics and treatment patterns were derived from a Swedish osteoporosis research database based on national registers and patient records. Current (standard) clinical management was compared with alternative scenarios mirroring Swedish treatment guidelines. Results: The national burden in terms of lost QALYs was estimated at 14,993 QALYs and the total economic cost at €776M. Scenario analyses showed that 382–3864 QALYs could be gained at a cost/QALY ranging from cost-saving to €31368, depending on the scenario. The margin of investment, i.e. the maximum amount that could be invested in the healthcare system to achieve these improvements up to the limit of the willingness to pay/QALY, was estimated at €199M on a population level (€3,634/patient). Conclusions: The analysis showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. From a cost-effectiveness perspective, there is also considerable room for investment to achieve these improvements in the management of osteoporosis.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Cost, Fracture, Osteoporosis, Quality-of-life, Register, Sweden
in
Osteoporosis International
pages
11 pages
publisher
Springer
external identifiers
  • scopus:85035789527
ISSN
0937-941X
DOI
10.1007/s00198-017-4325-4
language
English
LU publication?
yes
id
0d1afe71-0222-4dc0-8800-915a51ec83de
date added to LUP
2017-12-12 08:06:19
date last changed
2018-04-29 04:44:15
@article{0d1afe71-0222-4dc0-8800-915a51ec83de,
  abstract     = {<p>Summary: The objective was to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Results showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. Introduction: The purpose of this study is to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Methods: The analysis was carried out using a model that simulates the individual patients considered for pharmacological treatment during 1 year and their projected osteoporosis treatment pathway, quality-adjusted life years (QALYs) and costs over their remaining lifetime. All patients regardless of treatment or no treatment were simulated. Information on current management of osteoporosis in terms of patient characteristics and treatment patterns were derived from a Swedish osteoporosis research database based on national registers and patient records. Current (standard) clinical management was compared with alternative scenarios mirroring Swedish treatment guidelines. Results: The national burden in terms of lost QALYs was estimated at 14,993 QALYs and the total economic cost at €776M. Scenario analyses showed that 382–3864 QALYs could be gained at a cost/QALY ranging from cost-saving to €31368, depending on the scenario. The margin of investment, i.e. the maximum amount that could be invested in the healthcare system to achieve these improvements up to the limit of the willingness to pay/QALY, was estimated at €199M on a population level (€3,634/patient). Conclusions: The analysis showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. From a cost-effectiveness perspective, there is also considerable room for investment to achieve these improvements in the management of osteoporosis.</p>},
  author       = {Jonsson, E. and Hansson-Hedblom, A. and Ljunggren, Östen and Åkesson, K. and Spångeus, A. and Kanis, J. A. and Borgström, F.},
  issn         = {0937-941X},
  keyword      = {Cost,Fracture,Osteoporosis,Quality-of-life,Register,Sweden},
  language     = {eng},
  month        = {12},
  pages        = {11},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {A health economic simulation model for the clinical management of osteoporosis},
  url          = {http://dx.doi.org/10.1007/s00198-017-4325-4},
  year         = {2017},
}