UNLABELLED: 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.
UNLABELLED: 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.
Authors: Alexandra Papaioannou; Suzanne Morin; Angela M Cheung; Stephanie Atkinson; Jacques P Brown; Sidney Feldman; David A Hanley; Anthony Hodsman; Sophie A Jamal; Stephanie M Kaiser; Brent Kvern; Kerry Siminoski; William D Leslie Journal: CMAJ Date: 2010-10-12 Impact factor: 8.262
Authors: Marc-Antoine Krieg; Jacques Cornuz; Christiane Ruffieux; Guy Van Melle; Daniel Büche; Maximilian A Dambacher; Didier Hans; Florian Hartl; Hansjorg J Häuselmann; Marius Kraenzlin; Kurt Lippuner; Maurus Neff; Pierro Pancaldi; Rene Rizzoli; Franco Tanzi; Robert Theiler; Alan Tyndall; Claus Wimpfheimer; Peter Burckhardt Journal: J Bone Miner Res Date: 2006-09 Impact factor: 6.741
Authors: O Johnell; J A Kanis; A Odén; I Sernbo; I Redlund-Johnell; C Petterson; C De Laet; B Jönsson Journal: Osteoporos Int Date: 2003-10-30 Impact factor: 4.507
Authors: Ethel S Siris; Ya-Ting Chen; Thomas A Abbott; Elizabeth Barrett-Connor; Paul D Miller; Lois E Wehren; Marc L Berger Journal: Arch Intern Med Date: 2004-05-24
Authors: P Makras; K Athanasakis; N Boubouchairopoulou; S Rizou; A D Anastasilakis; J Kyriopoulos; G P Lyritis Journal: Osteoporos Int Date: 2015-03-05 Impact factor: 4.507
Authors: Mickaël Hiligsmann; Silvia M Evers; Wafa Ben Sedrine; John A Kanis; Bram Ramaekers; Jean-Yves Reginster; Stuart Silverman; Caroline E Wyers; Annelies Boonen Journal: Pharmacoeconomics Date: 2015-03 Impact factor: 4.981
Authors: John A Kanis; Nicholas C Harvey; Cyrus Cooper; Helena Johansson; Anders Odén; Eugene V McCloskey Journal: Arch Osteoporos Date: 2016-07-27 Impact factor: 2.617
Authors: Martin Kužma; Didier Hans; Tomáš Koller; Eva Némethová; Peter Jackuliak; Zdenko Killinger; Heinrich Resch; Juraj Payer Journal: J Bone Miner Metab Date: 2017-09-07 Impact factor: 2.626