Evidence map›Paper›PMID 40478456›Full record

ArticleArchives of osteoporosis2025

Cost‑effectiveness analysis of fracture liaison services in Iran.

Abdoreza Mousavi, Rajabali Daroudi, Noushin Fahimfar, Afshin Ostovar, Ali Akbari Sari, Mozhdeh Zabihiyeganeh, Mohammad Javad Mansourzadeh, Fatemeh Hajivalizadeh, Bagher Larijani, Alireza Raeisi

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Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Abdoreza MousaviDepartment of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Rajabali DaroudiDepartment of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. rdaroudi@sina.tums.ac.ir.
Noushin FahimfarOsteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. nfahimfar@sina.tums.ac.ir.
Afshin OstovarOsteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ali Akbari SariDepartment of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mozhdeh ZabihiyeganehBone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
Mohammad Javad MansourzadehOsteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh HajivalizadehCenter for Non-Communicable Diseases Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran.
Bagher LarijaniEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Alireza RaeisiDepartment of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Funding

Tehran University of Medical Sciences and Health Services IR.TUMS.SPH.REC.1400.238
6 · The paper itself

Abstract

This study evaluates the cost-effectiveness of a Fracture Liaison Service (FLS) compared to current practice for individuals aged 50 and older with fragility fractures in Iran. The FLS was associated with an additional cost of $50 and a gain of 0.03 QALYs, resulting in an incremental cost-effectiveness ratio of $1663 per QALY, demonstrating its cost-effectiveness. PURPOSE: This study aimed to assess the cost-effectiveness of a FLS program compared to current practice in Iran, from a societal perspective.

methodsThe target population was patients aged 50 years or older with recent sentinel fragility fractures. Data were collected using various resources, including previously published literature, treatment guidelines, and hospitals. A state-based microsimulation model with a lifetime horizon was designed to simulate costs and quality-adjusted life years (QALYs). Treatment pathways for patients under current practice and FLS were compared using incremental cost-effectiveness ratios (ICERs).

resultsFor patients aged 50 years and older with a sentinel fragility fracture, FLS was associated with an incremental cost of $50 and a gain of 0.03 QALYs compared to current practice. Consequently, the ICER was estimated at $1663 per QALY gained, which is below the willingness-to-pay (WTP) threshold of one GDP per capita ($4466 per QALY). Simulations showed that comparing the current practice, FLS could prevent 59 new fractures and 10 related deaths per 1000 patients. The one-way sensitivity analysis indicated that treatment efficacy and medication costs exert the greatest influence on the ICER.

conclusionThe findings of this study demonstrate that FLS is cost-effective compared to current practice in Iran. Given the significant prevalence of osteoporosis and the increasing aging population in Iran, these results underscore the potential of FLS to enhance patient outcomes.

Indexed as

Osteoporotic FracturesAgedAged, 80 and overCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHealth Care CostsHumansIranMaleMiddle AgedQuality-Adjusted Life YearsCost-effectivenessFracture liaison servicesFragility fractureOsteoporosis

Identifiers

PMID40478456

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.