Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature

C. H. Wu, I. J. Kao, W. C. Hung, S. C. Lin, H. C. Liu, M. H. Hsieh, S. Bagga, M. Achra, T. T. Cheng, R. S. Yang

研究成果: Review article

17 引文 斯高帕斯(Scopus)

摘要

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023–$28,800 US dollars (USD) in Japan to $14,513–$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards.

原文English
頁(從 - 到)1227-1242
頁數16
期刊Osteoporosis International
29
發行號6
DOIs
出版狀態Published - 2018 六月 1

    指紋

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

引用此

Wu, C. H., Kao, I. J., Hung, W. C., Lin, S. C., Liu, H. C., Hsieh, M. H., Bagga, S., Achra, M., Cheng, T. T., & Yang, R. S. (2018). Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature. Osteoporosis International, 29(6), 1227-1242. https://doi.org/10.1007/s00198-018-4411-2