Cost-effectiveness of FRAX®-based intervention thresholds for management of osteoporosis in Singaporean women. Chandran, M., Ganesan, G., Tan, K., Reginster, J., & Hiligsmann, M. Osteoporosis International, 32(1):133–144, January, 2021.
Cost-effectiveness of FRAX®-based intervention thresholds for management of osteoporosis in Singaporean women [link]Paper  doi  abstract   bibtex   
Introduction FRAX®-based intervention thresholds (ITs) were recently identified for osteoporosis management in Singapore. This study aimed to assess the cost-effectiveness of ITs in Singaporean women over the age of 50 years. Methods A validated Markov microsimulation model was used to estimate the lifetime healthcare costs (SGD2019) per qualityadjusted life-years (QALY) of generic alendronate compared with no treatment. Cost-effectiveness of age-dependent FRAX® major osteoporotic fracture (MOF) and hip fracture (HF) ITs was explored. In addition, ITs that would lead to cost-effectiveness were computed. Fracture incidence and cost data were obtained from the Ministry of Health and a previously published Singaporean study. A cost-effectiveness threshold of SGD 62,500/QALY gained was used, based conservatively on 0.7 times the Singapore GDP per capita. Results Generic alendronate was shown to be cost-effective at MOF ITs from the ages of 65 years, while HF ITs were costeffective from the ages of 60 and 65 years, assuming full and real-world adherence, respectively. A 14% MOF and a 3.5% HF ITs were required for alendronate to be cost-effective above 50 years. Conclusion This study suggests that the treatment of Singaporean women with alendronate is cost-effective at age-dependant FRAX® intervention thresholds at 65 years and older. Furthermore, identifying women at any age above 50 years with a 10-year risk of MOF or HF of 14% or 3.5% would lead to efficient use of resources. Cost-effective access to therapy for patients at high fracture probability based on FRAX® could contribute to reduce the growing burden of osteoporotic fractures in Singapore.
@article{chandran_cost-effectiveness_2021-1,
	title = {Cost-effectiveness of {FRAX}®-based intervention thresholds for management of osteoporosis in {Singaporean} women},
	volume = {32},
	issn = {0937-941X, 1433-2965},
	url = {https://link.springer.com/10.1007/s00198-020-05536-4},
	doi = {10.1007/s00198-020-05536-4},
	abstract = {Introduction FRAX®-based intervention thresholds (ITs) were recently identified for osteoporosis management in Singapore. This study aimed to assess the cost-effectiveness of ITs in Singaporean women over the age of 50 years. Methods A validated Markov microsimulation model was used to estimate the lifetime healthcare costs (SGD2019) per qualityadjusted life-years (QALY) of generic alendronate compared with no treatment. Cost-effectiveness of age-dependent FRAX® major osteoporotic fracture (MOF) and hip fracture (HF) ITs was explored. In addition, ITs that would lead to cost-effectiveness were computed. Fracture incidence and cost data were obtained from the Ministry of Health and a previously published Singaporean study. A cost-effectiveness threshold of SGD 62,500/QALY gained was used, based conservatively on 0.7 times the Singapore GDP per capita. Results Generic alendronate was shown to be cost-effective at MOF ITs from the ages of 65 years, while HF ITs were costeffective from the ages of 60 and 65 years, assuming full and real-world adherence, respectively. A 14\% MOF and a 3.5\% HF ITs were required for alendronate to be cost-effective above 50 years. Conclusion This study suggests that the treatment of Singaporean women with alendronate is cost-effective at age-dependant FRAX® intervention thresholds at 65 years and older. Furthermore, identifying women at any age above 50 years with a 10-year risk of MOF or HF of 14\% or 3.5\% would lead to efficient use of resources. Cost-effective access to therapy for patients at high fracture probability based on FRAX® could contribute to reduce the growing burden of osteoporotic fractures in Singapore.},
	language = {en},
	number = {1},
	urldate = {2022-01-06},
	journal = {Osteoporosis International},
	author = {Chandran, M. and Ganesan, G. and Tan, K.B. and Reginster, J.-Y. and Hiligsmann, M.},
	month = jan,
	year = {2021},
	pages = {133--144},
	file = {Chandran et al. - 2021 - Cost-effectiveness of FRAX®-based intervention thr.pdf:/Users/neil.hawkins/Zotero/storage/FRWPDKXM/Chandran et al. - 2021 - Cost-effectiveness of FRAX®-based intervention thr.pdf:application/pdf},
}

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