A model-based cost-effectiveness analysis of fracture liaison services in China

Nannan Li; Lei Si; Annelies Boonen; Joop P. van den Bergh; Mickael Hiligsmann

doi:10.1007/s11657-022-01170-1

A model-based cost-effectiveness analysis of fracture liaison services in China

Nannan Li, Lei Si, Annelies Boonen, Joop P. van den Bergh, Mickael Hiligsmann

Western Sydney University

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Summary: This study is a model-based cost-effectiveness analysis of fracture liaison services (FLS) in China, suggesting that FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. However, Chinese-specific real-world data is needed to confirm the results of our study. Purpose: The study aimed to assess the potential cost-effectiveness of fracture liaison services (FLS) from the Chinese healthcare perspective with a lifetime horizon. Methods: A previously validated Markov microsimulation model was adapted to estimate the cost-effectiveness of FLS compared to no-FLS. The evaluation was conducted in patients aged 65 years with a recent fracture. Treatment pathways were differentiated by gender, FLS attendance, osteoporosis diagnosis, treatment initiation, and adherence. Given the uncertainty in FLS cost, the cost in the base-case analysis was assumed at US$200. Analyses were also performed to determine the maximum cost for making the FLS cost-saving and cost-effective at the Chinese willingness-to-pay (WTP) threshold. One-way sensitivity analyses were conducted. Results: When compared with no-FLS, the FLS was dominant (lower costs, higher quality-adjusted life years) in our target population at the FLS cost of US$200 per patient. For every 100 patients who were admitted to the FLS, approximately four hip fractures, nine clinical vertebral fractures, and three wrist fractures would be avoided over their lifetimes. Our findings were robust to numerous one-way sensitivity analyses; however, the FLS was not cost-effective in patients aged 80 years and older. Conclusion: FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. Our study informs the potential cost-effectiveness of FLS and the knowledge gap in China; more future research incorporating Chinese-specific real-world data are needed to confirm the results of our study and to better evaluate the cost-effectiveness of FLS in China.

Original language	English
Article number	132
Number of pages	13
Journal	Archives of Osteoporosis
Volume	17
Issue number	1
DOIs	https://doi.org/10.1007/s11657-022-01170-1
Publication status	Published - 2022

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10.1007/s11657-022-01170-1

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title = "A model-based cost-effectiveness analysis of fracture liaison services in China",

abstract = "Summary: This study is a model-based cost-effectiveness analysis of fracture liaison services (FLS) in China, suggesting that FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. However, Chinese-specific real-world data is needed to confirm the results of our study. Purpose: The study aimed to assess the potential cost-effectiveness of fracture liaison services (FLS) from the Chinese healthcare perspective with a lifetime horizon. Methods: A previously validated Markov microsimulation model was adapted to estimate the cost-effectiveness of FLS compared to no-FLS. The evaluation was conducted in patients aged 65 years with a recent fracture. Treatment pathways were differentiated by gender, FLS attendance, osteoporosis diagnosis, treatment initiation, and adherence. Given the uncertainty in FLS cost, the cost in the base-case analysis was assumed at US$200. Analyses were also performed to determine the maximum cost for making the FLS cost-saving and cost-effective at the Chinese willingness-to-pay (WTP) threshold. One-way sensitivity analyses were conducted. Results: When compared with no-FLS, the FLS was dominant (lower costs, higher quality-adjusted life years) in our target population at the FLS cost of US$200 per patient. For every 100 patients who were admitted to the FLS, approximately four hip fractures, nine clinical vertebral fractures, and three wrist fractures would be avoided over their lifetimes. Our findings were robust to numerous one-way sensitivity analyses; however, the FLS was not cost-effective in patients aged 80 years and older. Conclusion: FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. Our study informs the potential cost-effectiveness of FLS and the knowledge gap in China; more future research incorporating Chinese-specific real-world data are needed to confirm the results of our study and to better evaluate the cost-effectiveness of FLS in China.",

author = "Nannan Li and Lei Si and Annelies Boonen and {van den Bergh}, {Joop P.} and Mickael Hiligsmann",

year = "2022",

doi = "10.1007/s11657-022-01170-1",

language = "English",

volume = "17",

journal = "Archives of Osteoporosis",

issn = "1862-3522",

publisher = "Springer London",

number = "1",

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AU - Li, Nannan

AU - Si, Lei

AU - Boonen, Annelies

AU - van den Bergh, Joop P.

AU - Hiligsmann, Mickael

PY - 2022

Y1 - 2022

N2 - Summary: This study is a model-based cost-effectiveness analysis of fracture liaison services (FLS) in China, suggesting that FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. However, Chinese-specific real-world data is needed to confirm the results of our study. Purpose: The study aimed to assess the potential cost-effectiveness of fracture liaison services (FLS) from the Chinese healthcare perspective with a lifetime horizon. Methods: A previously validated Markov microsimulation model was adapted to estimate the cost-effectiveness of FLS compared to no-FLS. The evaluation was conducted in patients aged 65 years with a recent fracture. Treatment pathways were differentiated by gender, FLS attendance, osteoporosis diagnosis, treatment initiation, and adherence. Given the uncertainty in FLS cost, the cost in the base-case analysis was assumed at US$200. Analyses were also performed to determine the maximum cost for making the FLS cost-saving and cost-effective at the Chinese willingness-to-pay (WTP) threshold. One-way sensitivity analyses were conducted. Results: When compared with no-FLS, the FLS was dominant (lower costs, higher quality-adjusted life years) in our target population at the FLS cost of US$200 per patient. For every 100 patients who were admitted to the FLS, approximately four hip fractures, nine clinical vertebral fractures, and three wrist fractures would be avoided over their lifetimes. Our findings were robust to numerous one-way sensitivity analyses; however, the FLS was not cost-effective in patients aged 80 years and older. Conclusion: FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. Our study informs the potential cost-effectiveness of FLS and the knowledge gap in China; more future research incorporating Chinese-specific real-world data are needed to confirm the results of our study and to better evaluate the cost-effectiveness of FLS in China.

AB - Summary: This study is a model-based cost-effectiveness analysis of fracture liaison services (FLS) in China, suggesting that FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. However, Chinese-specific real-world data is needed to confirm the results of our study. Purpose: The study aimed to assess the potential cost-effectiveness of fracture liaison services (FLS) from the Chinese healthcare perspective with a lifetime horizon. Methods: A previously validated Markov microsimulation model was adapted to estimate the cost-effectiveness of FLS compared to no-FLS. The evaluation was conducted in patients aged 65 years with a recent fracture. Treatment pathways were differentiated by gender, FLS attendance, osteoporosis diagnosis, treatment initiation, and adherence. Given the uncertainty in FLS cost, the cost in the base-case analysis was assumed at US$200. Analyses were also performed to determine the maximum cost for making the FLS cost-saving and cost-effective at the Chinese willingness-to-pay (WTP) threshold. One-way sensitivity analyses were conducted. Results: When compared with no-FLS, the FLS was dominant (lower costs, higher quality-adjusted life years) in our target population at the FLS cost of US$200 per patient. For every 100 patients who were admitted to the FLS, approximately four hip fractures, nine clinical vertebral fractures, and three wrist fractures would be avoided over their lifetimes. Our findings were robust to numerous one-way sensitivity analyses; however, the FLS was not cost-effective in patients aged 80 years and older. Conclusion: FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. Our study informs the potential cost-effectiveness of FLS and the knowledge gap in China; more future research incorporating Chinese-specific real-world data are needed to confirm the results of our study and to better evaluate the cost-effectiveness of FLS in China.

UR - https://hdl.handle.net/1959.7/uws:67803

U2 - 10.1007/s11657-022-01170-1

DO - 10.1007/s11657-022-01170-1

M3 - Article

SN - 1862-3522

VL - 17

JO - Archives of Osteoporosis

JF - Archives of Osteoporosis

IS - 1

M1 - 132

ER -

A model-based cost-effectiveness analysis of fracture liaison services in China

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