ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024
Cost-effectiveness analysis of fracture liaison services: a Markov model using Dutch real-world data.
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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 15 citations in OpenAlex.
- Aging-Driven Inter-Organ Crosstalk in Postmenopausal Osteoporosis: From Immunometabolic Drift to Multisystem Frailty.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Review
- Review
- Cost-utility analysis of coordinator services (FLS) in patients with femur fractures.Archives of osteoporosis · 2025Article
- Article
- Real-life effectiveness of a Fracture Liaison Service in reducing short-term mortality and second fractures after hip fracture: a five-year prospective study.Archives of osteoporosis · 2025Article
- Recommendations for the prevention of fragility fractures: a consensus from international experts and Ibero-American scientific societies.Archives of osteoporosis · 2025Article
- Cost‑effectiveness analysis of fracture liaison services in Iran.Archives of osteoporosis · 2025Article
- Cost-effectiveness of a multicomponent-adherence intervention in fracture liaison services.Expert review of pharmacoeconomics & outcomes research · 2024Article
- Societal costs before and up to 1 year after the first fracture liaison service visit in patients requiring anti-osteoporosis treatments.Archives of osteoporosis · 2024Article
- Perspectives on Fracture Liaison Service in Austria: clinical and economic considerations.Frontiers in endocrinology · 2024Review
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study assessed the lifetime cost-effectiveness of a fracture liaison service (FLS) compared to no-FLS in the Netherlands from a societal perspective and suggested that FLS was cost-effective in patients with a recent fracture aged 50 years and older. The implementation of FLS could lead to lifetime health-economic benefits.
introductionThe objective of this study was to investigate the lifetime cost-effectiveness of a fracture liaison service (FLS) compared to no-FLS in the Netherlands from a societal perspective and using real-world data.
methodsAnnual fracture incidence, treatment scenarios as well as treatment initiation in the years 2017-2019 were collected from a large secondary care hospital in the Netherlands. An individual-level, state transition model was designed to simulate lifetime costs and quality-adjusted life years (QALYs). Treatment pathways were differentiated by gender, presence of osteoporosis and/or prevalent vertebral fracture, and treatment status. Results were presented as incremental cost-effectiveness ratios (ICER). Both one-way and probabilistic sensitivity analyses were conducted.
resultsFor patients with a recent fracture aged 50 years and older, the presence of an FLS was associated with a lifetime €45 higher cost and 0.11 additional QALY gained leading to an ICER of €409 per QALY gained, indicating FLS was cost-effective compared to no-FLS at the Dutch threshold of €20,000/QALY. The FLS remained cost-effectiveness across different age categories. Our findings were robust in all one-way sensitivity analyses, the higher the treatment initiation rate in FLS, the greater the cost-effective of FLS. Probabilistic sensitivity analyses revealed that FLS was cost-effective in 90% of the simulations at the threshold of €20,000/QALY, with women 92% versus men 84% by gender.
conclusionThis study provides the first health-economic analysis of FLS in the Netherlands, suggesting the implementation of FLS could lead to lifetime health-economic benefits.
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