Cost-Effectiveness of Using Clinical Risk Factors with and without DXA for Osteoporosis Screening in Postmenopausal Women

Nov 1, 2009, 00:00
10.1111/j.1524-4733.2009.00577.x
https://www.valueinhealthjournal.com/article/S1098-3015(10)60316-6/fulltext
Title : Cost-Effectiveness of Using Clinical Risk Factors with and without DXA for Osteoporosis Screening in Postmenopausal Women
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(10)60316-6&doi=10.1111/j.1524-4733.2009.00577.x
First page :
Section Title :
Open access? : No
Section Order : 7

Background

According to several guidelines, the assessment of postmenopausal fracture risk should be based on clinical risk factors (CRFs) and bone density. Because measurement of bone density by dual x-ray absorptiometry (DXA) is quite expensive, there has been increasing interest to estimate fracture risk by CRFs.

Objective

The aim of this study was to determine the cost-effectiveness of osteoporosis screening of CRFs with and without DXA compared with no screening in postmenopausal women in Germany.

Methods

A cost-utility analysis and a budget-impact analysis were performed from the perspective of the statutory health insurance. A Markov model simulated costs and benefits discounted at 3% over lifetime.

Results

Cost-effectiveness of CRFs compared with no screening is €4607, €21,181, and €10,171 per quality-adjusted life-year (QALY) for 60-, 70-, and 80-year-old women, respectively. Cost-effectiveness of DXA plus CRFs compared with CRFs alone is €20,235 for 60-year-old women. In women above the age of 70, DXA plus CRFs dominates CRFs alone. DXA plus CRFs results in annual costs of €175 million, or 0.4% of the statutory health insurance's annual budget.

Conclusion

Funders should be careful in adopting a strategy based on CRFs alone instead of DXA plus CRFs. Only if DXA is not available, assessing CRFs only is an acceptable option in predicting a woman's risk of fracture.

Categories :
  • Budget Impact Analysis
  • Cost/Cost of Illness/Resource Use Studies
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Musculoskeletal Disorders
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • cost-utility analysis
  • modeling
  • osteoporosis
  • secondary prevention
  • women's health
Regions :
  • Global
ViH Article Tags :