Cost-effective intervention thresholds against osteoporotic fractures based on FRAX® in Switzerland
Journal article
Lippuner, K., Johansson, Helena, Borgström, F., Kanis, John A. and Rizzoli, R.. (2012). Cost-effective intervention thresholds against osteoporotic fractures based on FRAX® in Switzerland. Osteoporosis International. 23(11), pp. 2579 - 2589. https://doi.org/10.1007/s00198-011-1869-6
Authors | Lippuner, K., Johansson, Helena, Borgström, F., Kanis, John A. and Rizzoli, R. |
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Abstract | Summary: FRAX-based cost-effective intervention thresholds in the Swiss setting were determined. Assuming a willingness to pay at 2× Gross Domestic Product per capita, an intervention aimed at reducing fracture risk in women and men with a 10-year probability for a major osteoporotic fracture at or above 15% is cost-effective. Introduction: The fracture risk assessment algorithm FRAX® has been recently calibrated for Switzerland. The aim of the present analysis was to determine FRAX-based fracture probabilities at which intervention becomes cost-effective. Methods: A previously developed and validated state transition Markov cohort model was populated with Swiss epidemiological and cost input parameters. Cost-effective FRAX-based intervention thresholds ( cost-effectiveness approach ) and the cost-effectiveness of intervention with alendronate ( original molecule ) in subjects with a FRAX-based fracture risk equivalent to that of a woman with a prior fragility fracture and no other risk factor ( translational approach ) were calculated based on the Swiss FRAX model and assuming a willingness to pay of 2 times Gross Domestic Product per capita for one Quality-adjusted Life-Year. Results: In Swiss women and men aged 50 years and older, drug intervention aimed at decreasing fracture risk was cost-effective with a 10-year probability for a major osteoporotic fracture at or above 13.8% ( range 10.8% to 15.0% ) and 15.1% ( range 9.9% to 19.9% ), respectively. Age-dependent variations around these mean values were modest. Using the translational approach, treatment was cost-effective or cost-saving after the age 60 years in women and 55 in men who had previously sustained a fragility fracture. Using the latter approach leads to considerable underuse of the current potential for cost-effective interventions against fractures. Conclusions: Using a FRAX-based intervention threshold of 15% for both women and men should permit cost-effective access to therapy to patients at high fracture probability based on clinical risk factors and thereby contribute to further reduce the growing burden of osteoporotic fractures in Switzerland. |
Keywords | alendronate; cost-effectiveness; FRAX®; intervention thresholds; osteoporosis; Switzerland; 10-year fracture probability |
Year | 2012 |
Journal | Osteoporosis International |
Journal citation | 23 (11), pp. 2579 - 2589 |
Publisher | Springer-Verlag |
ISSN | 0937-941X |
Digital Object Identifier (DOI) | https://doi.org/10.1007/s00198-011-1869-6 |
Scopus EID | 2-s2.0-84864565291 |
Page range | 2579 - 2589 |
Research Group | Institute for Health and Ageing |
Publisher's version | File Access Level Controlled |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/89z61/cost-effective-intervention-thresholds-against-osteoporotic-fractures-based-on-frax-in-switzerland
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