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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
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
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
2008-01-16 12:26:43
date last changed
2017-09-03 04:41:45
@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},
  keyword      = {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},
  volume       = {36},
  year         = {2005},
}