ArticleClinicoEconomics and outcomes research : CEOR2024
Actions to Improve the Secondary Prevention of Fragility Fractures in Women with Postmenopausal Osteoporosis: A Social Return on Investment (SROI) Study.
Article in ClinicoEconomics and outcomes research : CEOR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Reduced Risk of Recurrent Fragility Fractures After a Primary Care-Based Fracture Prevention Intervention: A 20-Year Non-Randomized Controlled Follow-Up Study in Women Aged 70-100.Scandinavian journal of primary health care · 2026Article
- Recommendations for the prevention of fragility fractures: a consensus from international experts and Ibero-American scientific societies.Archives of osteoporosis · 2025Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: This study evaluates the Social Return on Investment (SROI) of implementing measures to prevent fragility fractures in postmenopausal women with osteoporosis (OP) in Spain. Methods: A group of 13 stakeholders identified necessary actions for improving refracture prevention and assessed the investment required from the Spanish National Health System (SNHS), considering direct, indirect, and intangible costs over a one-year period. Unitary costs were sourced from scientific literature and official data, and intangible costs were estimated through surveys on women's willingness to pay for better health-related quality of life. The SROI ratio was calculated from both a social perspective (including all returns) and the SNHS perspective (including only direct and intangible costs). A sensitivity analysis evaluated the returns in worst- and best-case scenarios over three years. Results: Stakeholders agreed on four main actions: 1) establishing fracture liaison services; 2) harmonizing clinical practice guidelines and provide training for healthcare professionals (HCPs); 3) promoting HCPs' adherence to fracture registries and 4) raising awareness of OP and fragility fractures. From the social perspective, implementing these actions would cost the SNHS €4,375,663 but yield a social return of €96,939,931 in the first year, resulting in a SROI ratio of €22.15 per euro invested (€28.69, 23.14, 24.29, and 10.70 for the four actions, respectively). From the SNHS perspective, the return would be €36,453,509 (€21,523,444 tangible), with a SROI of €8.33 (€4.92 tangible) and for the four actions: €9.99, 9.39, 8.45, and 3.79, respectively (€5.89, 5.54, 4.96 and 2.27 tangible). The investment would be lower than the return for all actions (3.49%, 4.32%, 4.12% and 9.34% of social perspective return, respectively) and scenarios. Conclusion: According to our SROI method, implementing different actions to improve secondary fracture prevention would achieve a considerable social benefit, which, in terms of direct, indirect, and intangible costs, would far outweigh the investment.
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