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Study: FRAX can be cost-effective tool in osteoporosis screening
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The WHO Fracture Risk Assessment Tool can be a cost-effective pre-screening tool for determining osteoporosis patients if patient follow-up and medication adherence are optimized, according to data recently presented at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases in Seville, Spain.
Researchers used an incremental cost-effectiveness ratio (ICER) expressed in costs (€) per quality-adjusted-life-year (QALY) gained to evaluate the cost-effectiveness of the screening/treatment (ST) strategy as opposed to no intervention. The ST strategy involved prescreening using the Fracture Risk Assessment Tool (FRAX) followed by a bone densitometry for patients with positive FRAX result combined with a 5-year branded alendronate therapy for women diagnosed with osteoporosis.
For the entire population (mean age 60 years), the ICER for the ST strategy vs. no intervention, assuming real-world and full adherence was estimated at €66,665 and €39504, respectively, per QALY gained. A decrease to €55,517 and €28,520, respectively, was seen in the population over 60 years (mean age 65 years).
ST strategy ICER decreases when the follow-up of a positive screening is improved and increasing fracture risk. Cost-effectiveness improved to €50,880 and €32,293, respectively, using the price of generic alendronate.
“[Bone mineral density] BMD should be performed in all individuals with positive FRAX score.” Mickael Hiligsmann, MD, Assistant Professor in Health Economics and Health Technology Assessment at Maastricht University and Invited Professor at University of Liége, Liége, Belgium, stated. “Furthermore, to improve the efficiency of the screening strategy, we suggest targeting screening on women with one or more clinical risk factors, or on women aged 65 years and older.”
Reference:
Hiligsmann M. Paper OC7. Presented at: World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. April 2-5, 2014; Seville, Spain.
Disclosure: Hiligsmann has no relevant financial disclosures.