Skip to main content
Erschienen in: Osteoporosis International 2/2017

04.10.2016 | Original Article

Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan

verfasst von: K. Moriwaki, S. Noto

Erschienen in: Osteoporosis International | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Summary

A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture.

Introduction

The purpose of this study was to estimate, from the perspective of Japan’s healthcare system, the cost-effectiveness of secondary fracture prevention by OLS relative to no therapy in patients with osteoporosis and a history of hip fracture.

Methods

A patient-level state transition model was developed to predict lifetime costs and quality-adjusted life years (QALYs) in patients with or without secondary fracture prevention by OLS. The incremental cost-effectiveness ratio (ICER) of secondary fracture prevention compared with no therapy was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results.

Results

Compared with no therapy, secondary fracture prevention in patients aged 65 with T-score of −2.5 resulted in an additional lifetime cost of $3396 per person and conferred an additional 0.118 QALY, resulting in an ICER of $28,880 per QALY gained. Deterministic sensitivity analyses showed that treatment duration and offset time strongly affect the cost-effectiveness of OLS. According to the results of scenario analyses, secondary fracture prevention by OLS was cost-saving compared with no therapy in patients with a family history of hip fracture and high alcohol intake.

Conclusions

Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture. In addition, secondary fracture prevention is less expensive than no therapy in high-risk patients with multiple risk factors.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, Sakata K (2016) Hip fracture incidence in Japan: Estimates of new patients in 2012 and 25-year trends. Osteoporos Int DOI 10.1007/s00198-015-3464-8: Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, Sakata K (2016) Hip fracture incidence in Japan: Estimates of new patients in 2012 and 25-year trends. Osteoporos Int DOI 10.​1007/​s00198-015-3464-8:
2.
Zurück zum Zitat Orimo H, Yaegashi Y, Onoda T, Fukushima Y, Hosoi T, Sakata K (2009) Hip fracture incidence in Japan: estimates of new patients in 2007 and 20-year trends. Arch Osteoporos 4:71–77CrossRefPubMedPubMedCentral Orimo H, Yaegashi Y, Onoda T, Fukushima Y, Hosoi T, Sakata K (2009) Hip fracture incidence in Japan: estimates of new patients in 2007 and 20-year trends. Arch Osteoporos 4:71–77CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Harada A, Matsui Y, Takemura M, Ito Z, Wakao N, Ota T (2005) Cost-utility analysis of osteoporosis. Nippon Ronen Igakkai Zasshi Japanese J Geriatrics 42:596–608CrossRef Harada A, Matsui Y, Takemura M, Ito Z, Wakao N, Ota T (2005) Cost-utility analysis of osteoporosis. Nippon Ronen Igakkai Zasshi Japanese J Geriatrics 42:596–608CrossRef
4.
Zurück zum Zitat Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90:14–21CrossRefPubMed Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90:14–21CrossRefPubMed
5.
Zurück zum Zitat McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14:1028–1034CrossRefPubMed McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14:1028–1034CrossRefPubMed
6.
Zurück zum Zitat Eisman JA, Bogoch ER, Dell R et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046CrossRefPubMed Eisman JA, Bogoch ER, Dell R et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046CrossRefPubMed
7.
Zurück zum Zitat Committee of Japanese Guidelines for the Prevention and Treatment of Osteoporosis (2015) The Japanese guidelines for the prevention and treatment of osteoporosis (2015 edition). Tokyo, Japan: Life Science Publishing; Japanese. Committee of Japanese Guidelines for the Prevention and Treatment of Osteoporosis (2015) The Japanese guidelines for the prevention and treatment of osteoporosis (2015 edition). Tokyo, Japan: Life Science Publishing; Japanese.
8.
Zurück zum Zitat McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, Adekunle F, Roberts D (2011) Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int 22:2083–2098CrossRefPubMed McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, Adekunle F, Roberts D (2011) Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int 22:2083–2098CrossRefPubMed
9.
Zurück zum Zitat Solomon DH, Patrick AR, Schousboe J, Losina E (2014) The potential economic benefits of improved postfracture care: a cost-effectiveness analysis of a fracture liaison service in the US health-care system. J Bone Miner Res 29:1667–1674CrossRefPubMedPubMedCentral Solomon DH, Patrick AR, Schousboe J, Losina E (2014) The potential economic benefits of improved postfracture care: a cost-effectiveness analysis of a fracture liaison service in the US health-care system. J Bone Miner Res 29:1667–1674CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Moriwaki K, Komaba H, Noto S, Yanagisawa S, Takiguchi T, Inoue H, Toujo T, Fukagawa M, Takahashi HE (2013) Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan. J Bone Miner Res 28:395–403CrossRefPubMed Moriwaki K, Komaba H, Noto S, Yanagisawa S, Takiguchi T, Inoue H, Toujo T, Fukagawa M, Takahashi HE (2013) Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan. J Bone Miner Res 28:395–403CrossRefPubMed
11.
Zurück zum Zitat Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ 3rd (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177CrossRefPubMed Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ 3rd (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177CrossRefPubMed
12.
Zurück zum Zitat Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M (2003) Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res 18:1547–1553CrossRefPubMed Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M (2003) Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res 18:1547–1553CrossRefPubMed
13.
Zurück zum Zitat Hagino H, Katagiri H, Okano T, Yamamoto K, Teshima R (2005) Increasing incidence of hip fracture in Tottori Prefecture, Japan: trend from 1986 to 2001. Osteoporos Int 16:1963–1968CrossRefPubMed Hagino H, Katagiri H, Okano T, Yamamoto K, Teshima R (2005) Increasing incidence of hip fracture in Tottori Prefecture, Japan: trend from 1986 to 2001. Osteoporos Int 16:1963–1968CrossRefPubMed
14.
Zurück zum Zitat Ross PD, Norimatsu H, Davis JW, Yano K, Wasnich RD, Fujiwara S, Hosoda Y, Melton LJ 3rd (1991) A comparison of hip fracture incidence among native Japanese, Japanese Americans, and American Caucasians. Am J Epidemiol 133:801–809CrossRefPubMed Ross PD, Norimatsu H, Davis JW, Yano K, Wasnich RD, Fujiwara S, Hosoda Y, Melton LJ 3rd (1991) A comparison of hip fracture incidence among native Japanese, Japanese Americans, and American Caucasians. Am J Epidemiol 133:801–809CrossRefPubMed
15.
Zurück zum Zitat Soen S, Fukunaga M, Sugimoto T et al (2013) Diagnostic criteria for primary osteoporosis: year 2012 revision. J Bone Miner Metab 31:247–257CrossRefPubMed Soen S, Fukunaga M, Sugimoto T et al (2013) Diagnostic criteria for primary osteoporosis: year 2012 revision. J Bone Miner Metab 31:247–257CrossRefPubMed
16.
Zurück zum Zitat Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S (2010) Applied methods of cost-effectiveness analysis in healthcare. Oxford University Press, New York, USA Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S (2010) Applied methods of cost-effectiveness analysis in healthcare. Oxford University Press, New York, USA
17.
Zurück zum Zitat De Laet CE, van Hout BA, Burger H, Hofman A, Pols HA (1997) Bone density and risk of hip fracture in men and women: cross sectional analysis. BMJ 315:221–225CrossRefPubMedPubMedCentral De Laet CE, van Hout BA, Burger H, Hofman A, Pols HA (1997) Bone density and risk of hip fracture in men and women: cross sectional analysis. BMJ 315:221–225CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Hagino H, Furukawa K, Fujiwara S, Okano T, Katagiri H, Yamamoto K, Teshima R (2009) Recent trends in the incidence and lifetime risk of hip fracture in Tottori, Japan. Osteoporos Int 20:543–548CrossRefPubMed Hagino H, Furukawa K, Fujiwara S, Okano T, Katagiri H, Yamamoto K, Teshima R (2009) Recent trends in the incidence and lifetime risk of hip fracture in Tottori, Japan. Osteoporos Int 20:543–548CrossRefPubMed
19.
Zurück zum Zitat Hagino H, Yamamoto K, Ohshiro H, Nakamura T, Kishimoto H, Nose T (1999) Changing incidence of hip, distal radius, and proximal humerus fractures in Tottori Prefecture, Japan. Bone 24:265–270CrossRefPubMed Hagino H, Yamamoto K, Ohshiro H, Nakamura T, Kishimoto H, Nose T (1999) Changing incidence of hip, distal radius, and proximal humerus fractures in Tottori Prefecture, Japan. Bone 24:265–270CrossRefPubMed
20.
Zurück zum Zitat Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259CrossRefPubMedPubMedCentral Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed
22.
Zurück zum Zitat Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA, Pols H, Tenenhouse A (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742CrossRefPubMed Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA, Pols H, Tenenhouse A (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742CrossRefPubMed
23.
Zurück zum Zitat Kanis JA, Johansson H, Oden A et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037CrossRefPubMed Kanis JA, Johansson H, Oden A et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037CrossRefPubMed
24.
Zurück zum Zitat Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162CrossRefPubMed Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162CrossRefPubMed
26.
Zurück zum Zitat Cummings SR, Black DM, Thompson DE et al (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 280:2077–2082CrossRefPubMed Cummings SR, Black DM, Thompson DE et al (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 280:2077–2082CrossRefPubMed
28.
Zurück zum Zitat Tsuboi M, Hasegawa Y, Suzuki S, Wingstrand H, Thorngren KG (2007) Mortality and mobility after hip fracture in Japan: a ten-year follow-up. J Bone Joint Surg (Br) 89:461–466CrossRef Tsuboi M, Hasegawa Y, Suzuki S, Wingstrand H, Thorngren KG (2007) Mortality and mobility after hip fracture in Japan: a ten-year follow-up. J Bone Joint Surg (Br) 89:461–466CrossRef
29.
Zurück zum Zitat Hayashi Y (2007) Economical viewpoint for treatment of osteoporosis. Nihon Rinsho 65(9):609–614PubMed Hayashi Y (2007) Economical viewpoint for treatment of osteoporosis. Nihon Rinsho 65(9):609–614PubMed
30.
Zurück zum Zitat Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. NICE technology appraisal guidance [TA161] [Internet]. UK: The National Institute for Health and Care Excellence; [cited 2016 Mar 18]. Available from: https://www.nice.org.uk/guidance/ta161. 2011. Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. NICE technology appraisal guidance [TA161] [Internet]. UK: The National Institute for Health and Care Excellence; [cited 2016 Mar 18]. Available from: https://​www.​nice.​org.​uk/​guidance/​ta161. 2011.
31.
Zurück zum Zitat Murad MH, Drake MT, Mullan RJ et al (2012) Clinical review. Comparative effectiveness of drug treatments to prevent fragility fractures: a systematic review and network meta-analysis. J Clin Endocrinol Metab 97:1871–1880CrossRefPubMed Murad MH, Drake MT, Mullan RJ et al (2012) Clinical review. Comparative effectiveness of drug treatments to prevent fragility fractures: a systematic review and network meta-analysis. J Clin Endocrinol Metab 97:1871–1880CrossRefPubMed
32.
Zurück zum Zitat Kanis JA, Cooper C, Hiligsmann M, Rabenda V, Reginster JY, Rizzoli R (2011) Partial adherence: a new perspective on health economic assessment in osteoporosis. Osteoporos Int 22:2565–2573CrossRefPubMed Kanis JA, Cooper C, Hiligsmann M, Rabenda V, Reginster JY, Rizzoli R (2011) Partial adherence: a new perspective on health economic assessment in osteoporosis. Osteoporos Int 22:2565–2573CrossRefPubMed
33.
Zurück zum Zitat Ström O, Borgström F, Kanis JA, Jönsson B (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20:23–34CrossRefPubMed Ström O, Borgström F, Kanis JA, Jönsson B (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20:23–34CrossRefPubMed
34.
Zurück zum Zitat National Health Insurance Price List. Tokyo, Japan: Jihou Press; Japanese. 2014. National Health Insurance Price List. Tokyo, Japan: Jihou Press; Japanese. 2014.
35.
Zurück zum Zitat Medical Fee Schedule. Tokyo, Japan: Igaku-tsushin-sya; Japanese. 2014. Medical Fee Schedule. Tokyo, Japan: Igaku-tsushin-sya; Japanese. 2014.
36.
Zurück zum Zitat Kondo A, Zierler BK, Isokawa Y, Hagino H, Ito Y (2009) Comparison of outcomes and costs after hip fracture surgery in three hospitals that have different care systems in Japan. Health Policy 91:204–210CrossRefPubMed Kondo A, Zierler BK, Isokawa Y, Hagino H, Ito Y (2009) Comparison of outcomes and costs after hip fracture surgery in three hospitals that have different care systems in Japan. Health Policy 91:204–210CrossRefPubMed
37.
Zurück zum Zitat Hagino H (2002) Cost-effectiveness of the treatment for osteoporosis. Nihon Rinsho 60(3):645–654PubMed Hagino H (2002) Cost-effectiveness of the treatment for osteoporosis. Nihon Rinsho 60(3):645–654PubMed
38.
Zurück zum Zitat Negami S (2011) Comparison of cost for distal radius fractures before and after DPC revision by using EVE. J Sapporo Soc Insur Gen Hosp 20:43 Negami S (2011) Comparison of cost for distal radius fractures before and after DPC revision by using EVE. J Sapporo Soc Insur Gen Hosp 20:43
39.
Zurück zum Zitat Reward for nursing care. Tokyo, Japan: Igaku-tsushin-sya; Japanese. 2014. Reward for nursing care. Tokyo, Japan: Igaku-tsushin-sya; Japanese. 2014.
40.
Zurück zum Zitat Nawata S, Yamada Y, Ikeda S, Ikegami N (2000) EuroQol study of the elderly general population: Relationship with IADL and other attributes Journal of Health Care and Society 10: Nawata S, Yamada Y, Ikeda S, Ikegami N (2000) EuroQol study of the elderly general population: Relationship with IADL and other attributes Journal of Health Care and Society 10:
41.
Zurück zum Zitat Hagino H, Nakamura T, Fujiwara S, Oeki M, Okano T, Teshima R (2009) Sequential change in quality of life for patients with incident clinical fractures: a prospective study. Osteoporos Int 20:695–702CrossRefPubMed Hagino H, Nakamura T, Fujiwara S, Oeki M, Okano T, Teshima R (2009) Sequential change in quality of life for patients with incident clinical fractures: a prospective study. Osteoporos Int 20:695–702CrossRefPubMed
42.
Zurück zum Zitat Imai H, Fujii Y, Fukuda Y, Nakao H, Yahata Y (2008) Health-related quality of life and beneficiaries of long-term care insurance in Japan. Health Policy 85:349–355CrossRefPubMed Imai H, Fujii Y, Fukuda Y, Nakao H, Yahata Y (2008) Health-related quality of life and beneficiaries of long-term care insurance in Japan. Health Policy 85:349–355CrossRefPubMed
43.
Zurück zum Zitat Fukuda T, Shiroiwa T, Ikeda S et al (2013) Guideline for economic evaluation of healthcare technologies in Japan. J Natl Inst Public Health 62:625–640 Fukuda T, Shiroiwa T, Ikeda S et al (2013) Guideline for economic evaluation of healthcare technologies in Japan. J Natl Inst Public Health 62:625–640
44.
Zurück zum Zitat Gafni A, Birch S (2006) Incremental cost-effectiveness ratios (ICERs): the silence of the lambda. Soc Sci Med 62:2091–2100CrossRefPubMed Gafni A, Birch S (2006) Incremental cost-effectiveness ratios (ICERs): the silence of the lambda. Soc Sci Med 62:2091–2100CrossRefPubMed
45.
Zurück zum Zitat Tosteson AN, Melton LJ 3rd, Dawson-Hughes B, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447CrossRefPubMedPubMedCentral Tosteson AN, Melton LJ 3rd, Dawson-Hughes B, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Ohkusa Y, Sugawara T (2006) Research for willingness to pay for one QALY gain. Iryo To Shakai 16:157–165CrossRef Ohkusa Y, Sugawara T (2006) Research for willingness to pay for one QALY gain. Iryo To Shakai 16:157–165CrossRef
Metadaten
Titel
Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan
verfasst von
K. Moriwaki
S. Noto
Publikationsdatum
04.10.2016
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 2/2017
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3777-2

Weitere Artikel der Ausgabe 2/2017

Osteoporosis International 2/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.