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]](https://bibbase.org/img/filetypes/link.svg "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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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":[{"propositions":[],"lastnames":["Chandran"],"firstnames":["M."],"suffixes":[]},{"propositions":[],"lastnames":["Ganesan"],"firstnames":["G."],"suffixes":[]},{"propositions":[],"lastnames":["Tan"],"firstnames":["K.B."],"suffixes":[]},{"propositions":[],"lastnames":["Reginster"],"firstnames":["J.-Y."],"suffixes":[]},{"propositions":[],"lastnames":["Hiligsmann"],"firstnames":["M."],"suffixes":[]}],"month":"January","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","bibtex":"@article{chandran_cost-effectiveness_2021-1,\n\ttitle = {Cost-effectiveness of {FRAX}®-based intervention thresholds for management of osteoporosis in {Singaporean} women},\n\tvolume = {32},\n\tissn = {0937-941X, 1433-2965},\n\turl = {https://link.springer.com/10.1007/s00198-020-05536-4},\n\tdoi = {10.1007/s00198-020-05536-4},\n\tabstract = {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. 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