Fracture liaison services for the evaluation and management  of patients with osteoporotic fracture: a cost-effectiveness  evaluation based on data collected over 8 years  of service provision

Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : A. R. McLellan & S. E. Wolowacz & E. A. Zimovetz & S. M. Beard & S. Lock & L. McCrink & F. Adekunle & D. Roberts
  • چاپ و سال / کشور: 2011

Description

Summary The cost-effectiveness of Fracture Liaison Services (FLSs) for prevention of secondary fracture in osteoporosis patients in the United Kingdom (UK), and the cost associated with their widespread adoption, were evaluated. An estimated 18 fractures were prevented and £21,000 saved per 1,000 patients. Setup across the UK would cost an estimated £9.7 million. Introduction Only 11% to 28% of patients with a fragility fracture receive osteoporosis treatment in the UK. FLSs provide an efficient means to identify patients and are endorsed by the Department of Health but have not been widely adopted. The objective of this study was to evaluate the cost-effectiveness of FLSs in the UK and the cost associated with their widespread adoption. Methods A cost-effectiveness and budget-impact model was developed, utilising detailed audit data collected by the West Glasgow FLS. Results For a hypothetical cohort of 1,000 fragilityfracture patients (740 requiring treatment), 686 received treatment in the FLS compared with 193 in usual care. Assessments and osteoporosis treatments cost an additional £83,598 and £206,544, respectively, in the FLS; 18 fractures (including 11 hip fractures) were prevented, giving an overall saving of £21,000. Setup costs for widespread adoption of FLSs across the UK were estimated at £9.7 million. Conclusions FLSs are cost-effective for the prevention of further fractures in fragility-fracture patients. The cost of widespread adoption of FLS across the UK is small in comparison with other service provision and would be expected to result in important benefits in fractures avoided and reduced hospital bed occupancy.
Osteoporos Int (2011) 22:2083–2098 DOI 10.1007/s00198-011-1534-0 Received: 8 July 2010 / Accepted: 13 December 2010 / Published online: 24 May 2011
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