ArticleBMC health services research2014
Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- A systematic review of the indirect and social costs studies in fragility fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Cost-effectiveness of opportunistic osteoporosis screening using chest radiographs with deep learning in Germany.Aging clinical and experimental research · 2025Article
- Health economics assessment of statin therapy initiation thresholds for atherosclerosis prevention in China: a cost-effectiveness analysis.International journal for equity in health · 2025Article
- Association of NLR and Ferritin in Osteoporotic Fractures Among Chinese Older Patients.Journal of inflammation research · 2025Article
- Cost-consequence analysis of continuous denosumab therapy for osteoporosis treatment in South Korea.BMC musculoskeletal disorders · 2024Article
- Association between systemic inflammatory response index and bone turnover markers in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study.Frontiers in medicine · 2024Article
- Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among postmenopausal women across eight European countries.Archives of osteoporosis · 2023Article
- Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis.Applied health economics and health policy · 2023Article
- Substantial changes in fracture rates in German hospitals in 2018 compared with 2002: an epidemiological study.Archives of orthopaedic and trauma surgery · 2022Article
- Hip Fracture Risk in Antiepileptic Drug Initiators and Non-Initiators with Alzheimer's Disease.Clinical epidemiology · 2021Article
- Osteoporosis in patients with rheumatoid arthritis: trends in the German National Database 2007-2017.Rheumatology international · 2020Article
- Burden of cardiovascular diseases associated with fine particulate matter in Beijing, China: an economic modelling study.BMJ global health · 2020Article
- Uptrend of cervical and sacral fractures underlie increase in spinal fractures in the elderly, 2003-2017: analysis of a state-wide population database.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
- Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?Osteoporosis and sarcopenia · 2020Article
- Cost-effectiveness and budget impact of the microprocessor-controlled knee C-Leg in transfemoral amputees with and without diabetes mellitus.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Osteoporosis Knowledge and Health Beliefs Among Female Community Leaders in Peru.Women's health reports (New Rochelle, N.Y.) · 2020Article
- Cost-effectiveness of pharmacological fracture prevention for osteoporosis as prescribed in clinical practice in France, Germany, Italy, Spain, and the United Kingdom.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
- Anticholinergic burden and fractures: a protocol for a methodological systematic review and meta-analysis.BMJ open · 2019Article
- [Osteoporosis-epidemiology and quality of care].Zeitschrift fur Gerontologie und Geriatrie · 2019Review
- Economic Evaluation of the 2016 Chinese Guideline and Alternative Risk Thresholds of Initiating Statin Therapy for the Management of Atherosclerotic Cardiovascular Disease.PharmacoEconomics · 2019Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOsteoporotic fractures cause a large health burden and substantial costs. This study estimated the expected fracture numbers and costs for the remaining lifetime of postmenopausal women in Germany.
methodsA discrete event simulation (DES) model which tracks changes in fracture risk due to osteoporosis, a previous fracture or institutionalization in a nursing home was developed. Expected lifetime fracture numbers and costs per capita were estimated for postmenopausal women (aged 50 and older) at average osteoporosis risk (AOR) and for those never suffering from osteoporosis. Direct and indirect costs were modeled. Deterministic univariate and probabilistic sensitivity analyses were conducted.
resultsThe expected fracture numbers over the remaining lifetime of a 50 year old woman with AOR for each fracture type (% attributable to osteoporosis) were: hip 0.282 (57.9%), wrist 0.229 (18.2%), clinical vertebral 0.206 (39.2%), humerus 0.147 (43.5%), pelvis 0.105 (47.5%), and other femur 0.033 (52.1%). Expected discounted fracture lifetime costs (excess cost attributable to osteoporosis) per 50 year old woman with AOR amounted to € 4,479 (€ 1,995). Most costs were accrued in the hospital € 1,743 (€ 751) and long-term care sectors € 1,210 (€ 620). Univariate sensitivity analysis resulted in percentage changes between -48.4% (if fracture rates decreased by 2% per year) and +83.5% (if fracture rates increased by 2% per year) compared to base case excess costs. Costs for women with osteoporosis were about 3.3 times of those never getting osteoporosis (€ 7,463 vs. € 2,247), and were markedly increased for women with a previous fracture.
conclusionThe results of this study indicate that osteoporosis causes a substantial share of fracture costs in postmenopausal women, which strongly increase with age and previous fractures.
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