Cooper, MS and Palmer, AJ and Seibel, MJ, Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study, Osteoporosis International, 23, (1) pp. 97-107. ISSN 1433-2965 (2012) [Refereed Article]
Copyright 2011 International Osteoporosis Foundation and National Osteoporosis Foundation
Summary: We evaluated the cost-effectiveness of a fracture liaison service prospectively designed to have a parallel control group treated by standard care. The clinical effectiveness of this service was associated with an incremental cost-effectiveness ratio versus standard care of Australian dollars (AUD) 17,291 per quality-adjusted life year (QALY) gained.
Introduction: Osteoporotic fractures are a major burden for national health services. The risk of re-fracture following an osteoporotic fracture is particularly high. In a study unique in prospectively having a control group treated by standard care, we recently demonstrated that a Minimal Trauma Fracture Liaison (MTFL) service significantly reduces the risk of refracture by 80%. Since the service involves greater use of resources, we have now evaluated whether it is cost-effective.
Methods: A Markov model was developed that incorporated fracture probabilities and resource utilization data (expressed in AUD) obtained directly from the 4-year MTFL service clinical study. Resource utilization, local cost and mortality data and fracture-related health utility data were used to calculate QALYs with the MTFL service and standard care. Main outcome measures were: additional costs of the MTFL service over standard care, the financial savings achieved through reduced fractures and changes in QALYs associated with reduced fractures calculated over a 10-year simulation period. Costs and QALYs were discounted at 5% annually. Sensitivity analyses quantified the effects of different assumptions of effectiveness and resource utilization associated with the MTFL service.
Results: The MTFL service improved QALYs by 0.089 years and led to increased costs of AUD 1,486 per patient versus standard care over the 10-year simulation period. The incremental cost-effectiveness ratio versus standard care was AUD 17,291 per QALY gained. Results were robust under all plausible assumptions.
Conclusions: The MTFL service is a cost-effective intervention to reduce recurrent osteoporotic fractures.
|Item Type:||Refereed Article|
|Keywords:||cost-effectiveness;, costs, fracture, fracture liaison service, health economics, osteoporosis re-fracture|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Rheumatology and Arthritis|
|Objective Group:||Health and Support Services|
|Objective Field:||Health Policy Economic Outcomes|
|Author:||Palmer, AJ (Professor Andrew Palmer)|
|Year Published:||2012 (online first 2011)|
|Web of Science® Times Cited:||39|
|Deposited By:||Menzies Institute for Medical Research|
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