Cost-effectiveness analysis of fracture liaison services: a Markov model using Dutch real-world data
Authors' conclusion
This study provides the first health-economic analysis of FLS in the Netherlands, suggesting the implementation of FLS could lead to lifetime health-economic benefits.
Study context
- Population
- Patients with a recent fracture aged 50 years and older, Netherlands; data from a large secondary care hospital, 2017–2019
- Comparison
- Fracture liaison service (FLS) vs no-FLS
- Outcome
- Lifetime costs and QALYs, as ICER
- Follow-up
- Lifetime
Methodological detailsMarkov model, individual-level state transition model, lifetime horizon, societal perspective, real-world data, one-way and probabilistic sensitivity analyses
- Markov model
- Individual-level state transition model
- Lifetime horizon
- Societal perspective
- Real-world data
- One-way and probabilistic sensitivity analyses
Main finding
As reported in the abstract
Lifetime incremental cost, QALYs and ICER
Incremental cost
45 €
Lifetime incremental cost, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER)
Additional QALY gained
0.11 QALY
Lifetime incremental cost, QALYs and ICER
ICER
409 € per QALY gained
cost-effective at Dutch threshold of €20,000/QALY
Further findings
Cost-effectiveness across age categories
- FLS remained cost-effective across different age categories
Probabilistic sensitivity analyses: simulations cost-effective at €20,000/QALY
- Overall
- 90%
- Women
- 92%
- Men
- 84%
One-way sensitivity analyses
- Findings robust in all one-way sensitivity analyses; higher FLS treatment initiation rate, greater cost-effectiveness
Original publication
Cost-effectiveness analysis of fracture liaison services: a Markov model using Dutch real-world data. Osteoporos Int. Published 3 October 2023. doi:10.
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