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Erschienen in: Osteoporosis International 1/2013

01.01.2013 | Original Article

Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight

verfasst von: J. T. Schousboe, M. Gourlay, H. A. Fink, B. C. Taylor, E. S. Orwoll, E. Barrett-Connor, L. J. Melton III, S. R. Cummings, K. E. Ensrud, For the Osteoporotic Fractures in Men (MrOS) and Study of Osteoporotic Fractures (SOF) Research Groups

Erschienen in: Osteoporosis International | Ausgabe 1/2013

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Abstract

Summary

We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55–65 years and men aged 55–75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective.

Introduction

Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years.

Methods

We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ −2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005–2006.

Results

Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years.

Conclusions

For women aged 55–65 years and men aged 55–75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.
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Metadaten
Titel
Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight
verfasst von
J. T. Schousboe
M. Gourlay
H. A. Fink
B. C. Taylor
E. S. Orwoll
E. Barrett-Connor
L. J. Melton III
S. R. Cummings
K. E. Ensrud
For the Osteoporotic Fractures in Men (MrOS) and Study of Osteoporotic Fractures (SOF) Research Groups
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 1/2013
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-1936-7

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