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Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden

Kanis, JA; Johnell, Olof LU ; Oden, A; Borgstrom, F; Johansson, H; De Laet, C and Jonsson, B (2005) In Osteoporosis International 16(1). p.41439-41439
Abstract
The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in men and women, based on data from Sweden. We modeled the effects of a treatment costing $500 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect for a further 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, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of approximately $45,000/QALY gained was used. Cost of added years was included in a sensitivity analysis. With the base... (More)
The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in men and women, based on data from Sweden. We modeled the effects of a treatment costing $500 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect for a further 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, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of approximately $45,000/QALY gained was used. Cost of added years was included in a sensitivity analysis. With the base case ($500 per year; 35% efficacy) treatment in women was cost-effective with a 10-year hip fracture probability that ranged from 1.2% at the age of 50 years to 7.4% at the age of 80 years. Similar results were observed in men except that the threshold for cost-effectiveness was higher at younger ages than in women (2.0 vs 1.2%, respectively, at the age of 50 years). Intervention thresholds were sensitive to the assumed effectiveness and intervention cost. 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. 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 at moderately increased fracture risk. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
threshold, osteoporotic fracture, intervention, hip fracture, cost of added years, cost-effectiveness
in
Osteoporosis International
volume
16
issue
1
pages
41439 - 41439
publisher
Springer
external identifiers
  • wos:000226284900002
  • pmid:15103452
  • scopus:13244251126
ISSN
1433-2965
DOI
10.1007/s00198-004-1623-4
language
English
LU publication?
yes
id
397275ec-56c5-4e54-a7bc-723ec4b199d4 (old id 897675)
date added to LUP
2008-01-16 12:29:51
date last changed
2017-09-24 04:28:56
@article{397275ec-56c5-4e54-a7bc-723ec4b199d4,
  abstract     = {The aim of this study was to determine the threshold of fracture probability at which interventions became cost-effective in men and women, based on data from Sweden. We modeled the effects of a treatment costing $500 per year given for 5 years that decreased the risk of all osteoporotic fractures by 35% followed by a waning of effect for a further 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, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of approximately $45,000/QALY gained was used. Cost of added years was included in a sensitivity analysis. With the base case ($500 per year; 35% efficacy) treatment in women was cost-effective with a 10-year hip fracture probability that ranged from 1.2% at the age of 50 years to 7.4% at the age of 80 years. Similar results were observed in men except that the threshold for cost-effectiveness was higher at younger ages than in women (2.0 vs 1.2%, respectively, at the age of 50 years). Intervention thresholds were sensitive to the assumed effectiveness and intervention cost. 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. 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 at moderately increased fracture risk.},
  author       = {Kanis, JA and Johnell, Olof and Oden, A and Borgstrom, F and Johansson, H and De Laet, C and Jonsson, B},
  issn         = {1433-2965},
  keyword      = {threshold,osteoporotic fracture,intervention,hip fracture,cost of added years,cost-effectiveness},
  language     = {eng},
  number       = {1},
  pages        = {41439--41439},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden},
  url          = {http://dx.doi.org/10.1007/s00198-004-1623-4},
  volume       = {16},
  year         = {2005},
}