Screening for osteoporosis in older men with a history of falls: benefits at acceptable costs
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Screening for osteoporosis in older men with a history of falls: benefits at acceptable costs Screening for osteoporosis using dual-energy x-ray absorptiometry (DXA) followed by osteoporosis treatment in older men with a history of falls is a cost-effective use of resources in the US, according to a study published in JAMA Network Open. The study used a Markov model to evaluate the long-term health benefits and costs of screening with DXA followed by osteoporosis treatment if indicated, compared with usual care (no screening), in a hypothetical cohort of community-dwelling men aged 65 years in the US who had fallen at least once in the past year. It was assumed that those diagnosed with osteoporosis would receive alendronate sodium 70mg orally once a week for 5 years. The model showed that for the base-case population, 1876 men needed to undergo screening to prevent 1 hip fracture and 746 men needed to undergo screening to prevent 1 major osteoporotic fracture. Screening was estimated to provide a gain of 0.0026 quality-adjusted life-years (QALYs) at a cost increase of $US87 per person (year 2019 value), compared with usual care. The incremental cost-effectiveness ratio for screening was $33 169 per QALY gained. This value suggests that the screening strategy is cost effective, compared with usual care, at the conventional willingness-to-pay threshold of $100 000 per QALY gained. The results were sensitive to the age at screening, with improved health outcomes and cost savings if the target population was aged > 77 years. The study suggests that "Medicare coverage of screening with DXA could be expanded to older men with a history of falls," concludes the researcher. Ito K. Cost-effectiveness of Screening for Osteoporosis in Older Men With a History of Falls. JAMA Network Open : 1 Dec 2020. Available from: URL: http:// dx.doi.org/10.1001/jamanetworkopen.2020.27584
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PharmacoEconomics & Outcomes News 12 Dec 2020 No. 868
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