Evaluación económica de la prevención primaria de las fracturas de cadera por fragilidad: estimación del riesgo y coste-efectividad del tratamiento
Objective: To perform an economic evaluation of primary prevention of osteoporotichip fractures to find out the level of individual risk of fracture that determines cost-effectiveness of treatment. Methods: A discrete event simulation model representing the process of risk assessment and fracture events was built, taking into account all costs related to these processes. The model analyzed a cohort of women aged 60 years or older. The model parameters were estimated from several sources of information, official statistics and research studies. Decisions on treatment or risk reassessment were based on FRAX® index and optimal cut points for this index have been searched to distribute treatment and bone densitometries in the most cost-effective manner. That is, treating the minimal number of women avoiding the maximal number of hip fractures. Treatment adherence and effectiveness have been taken into account. Results: The analysis of a cohort of 3,000 women shows a decrease of the number of fractures in 20 (from 259 to 244) when primary prevention with alendronate is used following the current proposed strategy of risk assessment. The cost of prevention is more than 3 million euro, while savings due to avoided fractures is more than 95,000 euro. Conclusions: Primary prevention of hip fragility fractures is a (health and social) care spending that is not offset by the reduction in the number of fractures. Primary prevention strategies should be improved to achieve cost-effectiveness preventive treatments of fragility fractures.
Fractures; Hip; Prevention; Cost effectiveness
Tebé-Cordomí C, Comas M, Castells X, Espallargues-Carreras M. Evaluación económica de la prevención primaria de las fracturas de cadera por fragilidad: estimación del riesgo y coste-efectividad del tratamiento. Barcelona: Agència de Qualitat i Avaluació Sanitàries de Catalunya; 2014.
Use this identifier for quote and/or link this documenthttps://hdl.handle.net/11351/3029
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