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A health economic simulation model for the clinical management of osteoporosis.

https://arctichealth.org/en/permalink/ahliterature298501
Source
Osteoporos Int. 2018 03; 29(3):545-555
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2018
Author
E Jonsson
A Hansson-Hedblom
Ö Ljunggren
K Åkesson
A Spångeus
J A Kanis
F Borgström
Author Affiliation
Quantify Research, Hantverkargatan 8, 112 21, Stockholm, SE, Sweden. emma.jonsson@quantifyresearch.com.
Source
Osteoporos Int. 2018 03; 29(3):545-555
Date
03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Bone Density
Bone Density Conservation Agents - economics - therapeutic use
Cost-Benefit Analysis
Drug Substitution - economics
Female
Health Care Costs - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Models, Econometric
Osteoporosis - diagnosis - drug therapy - economics - epidemiology
Osteoporotic Fractures - economics - epidemiology - prevention & control
Quality of Life
Quality-Adjusted Life Years
Registries
Sweden - epidemiology
Abstract
The objective was to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice. Results showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings.
The purpose of this study is to estimate the burden of osteoporosis in Sweden based on current clinical practice and the cost-effectiveness of improvements in the management of osteoporosis over the clinical management compared to current clinical practice.
The analysis was carried out using a model that simulates the individual patients considered for pharmacological treatment during 1 year and their projected osteoporosis treatment pathway, quality-adjusted life years (QALYs) and costs over their remaining lifetime. All patients regardless of treatment or no treatment were simulated. Information on current management of osteoporosis in terms of patient characteristics and treatment patterns were derived from a Swedish osteoporosis research database based on national registers and patient records. Current (standard) clinical management was compared with alternative scenarios mirroring Swedish treatment guidelines.
The national burden in terms of lost QALYs was estimated at 14,993 QALYs and the total economic cost at €776M. Scenario analyses showed that 382-3864 QALYs could be gained at a cost/QALY ranging from cost-saving to €31368, depending on the scenario. The margin of investment, i.e. the maximum amount that could be invested in the healthcare system to achieve these improvements up to the limit of the willingness to pay/QALY, was estimated at €199M on a population level (€3,634/patient).
The analysis showed that better compliance to treatment guidelines is associated with better projected outcomes and cost-savings. From a cost-effectiveness perspective, there is also considerable room for investment to achieve these improvements in the management of osteoporosis.
PubMed ID
29196775 View in PubMed
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