OBJECTIVES : Treatment for osteoporosis is widely available – nonetheless, suboptimal screening and linkage to care (SLTC) leads to additional, preventable fractures. We estimate future fracture burden amongst Greek post-menopausal women aged 50-74, with one prior osteoporotic fracture, in the next 10 years, applying two scenarios: the current, assuming an 8.6% background SLTC, and a hypothetical, assuming 100% SLTC.

METHODS : A cohort stochastic model was developed for a hypothetical cohort of 50,000 women. The model followed them as they progressed in age while remaining in or exiting various health states. Women exited the model only through death. Costs were calculated for screening and treating cohort population and for the decrease in new fractures, from the perspective of the third-party payer, namely the National Organization for Health Services Provision (EOPYY).

RESULTS : Applying the new versus the current scenario would result in a reduction in deaths (-0.6%) and fractures (-4.3%) amongst the cohort over 10 years. In the new scenario, treatment initiations and total screenings increased almost 10-fold versus the current scenario, at an incremental cost of 27.83€ per woman per year in the cohort. Key cost drivers of the difference in costs were screening and treatment costs in the new scenario and vertebral and hip fractures costs in the current scenario. Applying the new scenario led to greater reductions in costs associated with vertebral (-8.1%) and hip (-5.5%) fractures, followed by savings in other non-vertebral (-3.0%) and forearm (-2.5%) fractures.

CONCLUSIONS : Applying a 100% SLTC strategy amongst post-menopausal women aged 50-74, with one prior osteoporotic fracture would result in additional averted deaths and fractures at a manageable incremental cost, from the perspective of the third-party payer. These findings confirm the importance of integrated disease management for osteoporosis, which should include comprehensive SLTC.