ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Vertebral fracture assessment (VFA) for osteoporosis screening in US postmenopausal women: is it cost-effective?
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Incidence and risk factors of poor prognosis in patients with OVCF following day surgery of percutaneous kyphoplasty: a retrospective study.BMC musculoskeletal disorders · 2025Article
- Updates on the Role of DXA in the Evaluation and Monitoring of Osteoporosis.Current rheumatology reports · 2025Review
- Cost-Effectiveness of Artificial Intelligence-Based Opportunistic Compression Fracture Screening of Existing Radiographs.Journal of the American College of Radiology : JACR · 2024Article
- Analysis of Long-Term Medical Expenses in Vertebral Fracture Patients.Clinics in orthopedic surgery · 2023Article
- Adjusting FRAX Estimates of Fracture Probability Based on a Positive Vertebral Fracture Assessment.JAMA network open · 2023Article
- Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among postmenopausal women across eight European countries.Archives of osteoporosis · 2023Article
- Recommendations on the post-acute management of the osteoporotic fracture - Patients with "very-high" Re-fracture risk.Journal of orthopaedic translation · 2022Article
- The clinician's guide to prevention and treatment of osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- The prevalence of vertebral fractures among Indian perimenopausal women and its association with ovarian biomarkers.Journal of bone and mineral metabolism · 2022Article
- Inter-observer agreement of vertebral fracture assessment with dual-energy x-ray absorptiometry equipment.Archives of osteoporosis · 2021Article
- The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations.Archives of osteoporosis · 2021Review
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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
Vertebral fracture assessment (VFA) is cost-effective when it was incorporated in the routine screening for osteoporosis in community-dwelling women aged ≥ 65 years, which support guidelines, such as the National Osteoporosis Foundation (NOF) for the diagnostic use of VFA as an important addition to fracture risk assessment.
introductionTo evaluate the cost-effectiveness of VFA as a screening tool to reduce future fracture risk in US community-dwelling women aged ≥ 65 years.
methodsAn individual-level state-transition cost-effectiveness model from a healthcare perspective was constructed using derived data from published literature. The time horizon was lifetime. Five screening strategies were compared, including no screening at all, central dual-energy X-ray absorptiometry (DXA) only, VFA only, central DXA followed by VFA if the femoral neck T-score (FN-T) ≤ - 1.5, or if the FN-T ≤ - 1.0. Various initiation ages and rescreening intervals were evaluated. Oral bisphosphonate treatment for 5-year periods was assumed. Incremental cost-effectiveness ratios (2017 US dollars per quality-adjusted life-year (QALY) gained) were used as the outcome measure.
resultsThe incorporation of VFA slightly increased life expectancy by 0.1 years and reduced the number of subsequent osteoporotic fractures by 3.7% and 7.7% compared with using DXA alone and no screening, respectively, leading to approximately 30 billion dollars saved. Regardless of initiation ages and rescreening intervals, central DXA followed by VFA if the FN-T ≤ - 1.0 was most cost-effective ($40,792 per QALY when the screening is initiated at age 65 years and with rescreening every 5 years). Results were robust to change in VF incidence and medication costs.
conclusionIn women aged ≥ 65 years, VFA is cost-effective when it was incorporated in routine screening for osteoporosis. Our findings support the National Osteoporosis Foundation (NOF) guidelines for the diagnostic use of VFA as an important addition to fracture risk assessment.
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