Literature DB >> 29196775

A health economic simulation model for the clinical management of osteoporosis.

E Jonsson1, A Hansson-Hedblom2, Ö Ljunggren3, K Åkesson4, A Spångeus5, J A Kanis6,7, F Borgström2,8.   

Abstract

The objective was to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Results showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings.
INTRODUCTION: The purpose of this study is to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice.
METHODS: The analysis was carried out using a model that simulates the individual patients considered for pharmacological treatment during 1 year and their projected osteoporosis treatment pathway, quality-adjusted life years (QALYs) and costs over their remaining lifetime. All patients regardless of treatment or no treatment were simulated. Information on current management of osteoporosis in terms of patient characteristics and treatment patterns were derived from a Swedish osteoporosis research database based on national registers and patient records. Current (standard) clinical management was compared with alternative scenarios mirroring Swedish treatment guidelines.
RESULTS: The national burden in terms of lost QALYs was estimated at 14,993 QALYs and the total economic cost at €776M. Scenario analyses showed that 382-3864 QALYs could be gained at a cost/QALY ranging from cost-saving to €31368, depending on the scenario. The margin of investment, i.e. the maximum amount that could be invested in the healthcare system to achieve these improvements up to the limit of the willingness to pay/QALY, was estimated at €199M on a population level (€3,634/patient).
CONCLUSIONS: The analysis showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. From a cost-effectiveness perspective, there is also considerable room for investment to achieve these improvements in the management of osteoporosis.

Entities:  

Keywords:  Cost; Fracture; Osteoporosis; Quality-of-life; Register; Sweden

Mesh:

Substances:

Year:  2017        PMID: 29196775     DOI: 10.1007/s00198-017-4325-4

Source DB:  PubMed          Journal:  Osteoporos Int        ISSN: 0937-941X            Impact factor:   4.507


  25 in total

1.  Swedish population health-related quality of life results using the EQ-5D.

Authors:  K Burström; M Johannesson; F Diderichsen
Journal:  Qual Life Res       Date:  2001       Impact factor: 4.147

2.  The burden of osteoporotic fractures: a method for setting intervention thresholds.

Authors:  J A Kanis; A Oden; O Johnell; B Jonsson; C de Laet; A Dawson
Journal:  Osteoporos Int       Date:  2001       Impact factor: 4.507

3.  Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness.

Authors:  Mikael Svensson; Fredrik O L Nilsson; Karl Arnberg
Journal:  Pharmacoeconomics       Date:  2015-11       Impact factor: 4.981

Review 4.  Coordinator-based systems for secondary prevention in fragility fracture patients.

Authors:  D Marsh; K Akesson; D E Beaton; E R Bogoch; S Boonen; M-L Brandi; A R McLellan; P J Mitchell; J E M Sale; D A Wahl
Journal:  Osteoporos Int       Date:  2011-05-24       Impact factor: 4.507

5.  Costs and quality of life associated with osteoporosis-related fractures in Sweden.

Authors:  Fredrik Borgström; Niklas Zethraeus; Olof Johnell; Lars Lidgren; Sari Ponzer; Olle Svensson; Peter Abdon; Ewald Ornstein; Karl Lunsjö; Karl Göran Thorngren; Ingemar Sernbo; Clas Rehnberg; Bengt Jönsson
Journal:  Osteoporos Int       Date:  2005-11-09       Impact factor: 4.507

6.  Cost-effectiveness of alendronate in the treatment of postmenopausal women in 9 European countries--an economic evaluation based on the fracture intervention trial.

Authors:  O Ström; F Borgström; S S Sen; S Boonen; P Haentjens; O Johnell; J A Kanis
Journal:  Osteoporos Int       Date:  2007-02-28       Impact factor: 4.507

7.  Excess mortality after hospitalisation for vertebral fracture.

Authors:  John A Kanis; Anders Oden; Olof Johnell; Chris De Laet; Bengt Jonsson
Journal:  Osteoporos Int       Date:  2003-11-04       Impact factor: 4.507

Review 8.  Swedish osteoporosis care.

Authors:  Emma Jonsson; Daniel Eriksson; Kristina Åkesson; Östen Ljunggren; Stina Salomonsson; Fredrik Borgström; Oskar Ström
Journal:  Arch Osteoporos       Date:  2015-08-11       Impact factor: 2.617

9.  The components of excess mortality after hip fracture.

Authors:  J A Kanis; A Oden; O Johnell; C De Laet; B Jonsson; A K Oglesby
Journal:  Bone       Date:  2003-05       Impact factor: 4.398

Review 10.  Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA).

Authors:  E Hernlund; A Svedbom; M Ivergård; J Compston; C Cooper; J Stenmark; E V McCloskey; B Jönsson; J A Kanis
Journal:  Arch Osteoporos       Date:  2013-10-11       Impact factor: 2.617

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  2 in total

1.  Selection of risk assessment methods for osteoporosis screening in postmenopausal women with low-energy fractures: A comparison of fracture risk assessment tool, digital X-ray radiogrammetry, and dual-energy X-ray absorptiometry.

Authors:  Mischa Woisetschläger; Simona Chisalita; Marta Vergara; Anna Spångeus
Journal:  SAGE Open Med       Date:  2022-01-15

2.  Photon-counting detector CT and energy-integrating detector CT for trabecular bone microstructure analysis of cubic specimens from human radius.

Authors:  Benjamin Klintström; Lilian Henriksson; Rodrigo Moreno; Alexandr Malusek; Örjan Smedby; Mischa Woisetschläger; Eva Klintström
Journal:  Eur Radiol Exp       Date:  2022-07-27
  2 in total

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