The University of Southampton
University of Southampton Institutional Repository

The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study

The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study
The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study
The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures. To make decisions about whether to implement any screening program, we should also consider whether the program is likely to be a good use of health care resources, ie, is it cost-effective? The cost per gained quality adjusted life year of screening for fracture risk has not previously been demonstrated in an economic evaluation alongside a clinical trial. We conducted a “within trial” economic analysis alongside the SCOOP study from the perspective of a national health payer, the UK National Health Service (NHS). The main outcome measure in the economic analysis was the cost per quality adjusted life year (QALY) gained over a 5-year time period. We also estimated cost per osteoporosis-related fracture prevented and the cost per hip fracture prevented. The screening arm had an average incremental QALY gain of 0.0237 (95% confidence interval –0.0034 to 0.0508) for the 5-year follow-up. The incremental cost per QALY gained was £2772 compared with the control arm. Cost-effectiveness acceptability curves indicated a 93% probability of the intervention being cost-effective at values of a QALY greater than £20,000. The intervention arm prevented fractures at a cost of £4478 and £7694 per fracture for osteoporosis-related and hip fractures, respectively. The current study demonstrates that a systematic, community-based screening program of fracture risk in older women in the UK represents a highly cost-effective intervention.
0884-0431
845-851
Turner, D.A.
9d642893-f55f-446e-b325-4bab84fe6297
Khioe, Rebekah F S
93831b07-2c55-4e71-8bed-01d71f0a968e
Shepstone, Lee
7ca551e6-b5ca-4984-a5c7-8d6983f23580
Lenaghan, Elizabeth
c4aefa86-9e5b-40dd-9a9e-0cd562bcb916
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Gittoes, Neil
6040182f-b612-489e-b26c-3d98fea3d222
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Holland, Richard
f2fb8045-c472-4243-95c3-84256ed043a2
Howe, Amanda
01775084-8b2d-48e7-a1a7-966aa5231416
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
O'Neill, Terence W
b40358f0-5719-41f9-9855-0814aa9af4b5
Torgerson, David J.
2b48b54a-4cc1-4833-864f-5b3d1b9fbc66
Fordham, Richard
237d629e-e715-4b58-8329-1acbb08d90e7
SCOOP Study Team
Turner, D.A.
9d642893-f55f-446e-b325-4bab84fe6297
Khioe, Rebekah F S
93831b07-2c55-4e71-8bed-01d71f0a968e
Shepstone, Lee
7ca551e6-b5ca-4984-a5c7-8d6983f23580
Lenaghan, Elizabeth
c4aefa86-9e5b-40dd-9a9e-0cd562bcb916
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Gittoes, Neil
6040182f-b612-489e-b26c-3d98fea3d222
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Holland, Richard
f2fb8045-c472-4243-95c3-84256ed043a2
Howe, Amanda
01775084-8b2d-48e7-a1a7-966aa5231416
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
O'Neill, Terence W
b40358f0-5719-41f9-9855-0814aa9af4b5
Torgerson, David J.
2b48b54a-4cc1-4833-864f-5b3d1b9fbc66
Fordham, Richard
237d629e-e715-4b58-8329-1acbb08d90e7

Turner, D.A., Khioe, Rebekah F S, Shepstone, Lee, Lenaghan, Elizabeth, Cooper, Cyrus, Gittoes, Neil, Harvey, Nicholas, Holland, Richard, Howe, Amanda, McCloskey, Eugene, O'Neill, Terence W, Torgerson, David J. and Fordham, Richard , SCOOP Study Team (2018) The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. Journal of Bone and Mineral Research, 33 (5), 845-851. (doi:10.1002/jbmr.3381).

Record type: Article

Abstract

The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures. To make decisions about whether to implement any screening program, we should also consider whether the program is likely to be a good use of health care resources, ie, is it cost-effective? The cost per gained quality adjusted life year of screening for fracture risk has not previously been demonstrated in an economic evaluation alongside a clinical trial. We conducted a “within trial” economic analysis alongside the SCOOP study from the perspective of a national health payer, the UK National Health Service (NHS). The main outcome measure in the economic analysis was the cost per quality adjusted life year (QALY) gained over a 5-year time period. We also estimated cost per osteoporosis-related fracture prevented and the cost per hip fracture prevented. The screening arm had an average incremental QALY gain of 0.0237 (95% confidence interval –0.0034 to 0.0508) for the 5-year follow-up. The incremental cost per QALY gained was £2772 compared with the control arm. Cost-effectiveness acceptability curves indicated a 93% probability of the intervention being cost-effective at values of a QALY greater than £20,000. The intervention arm prevented fractures at a cost of £4478 and £7694 per fracture for osteoporosis-related and hip fractures, respectively. The current study demonstrates that a systematic, community-based screening program of fracture risk in older women in the UK represents a highly cost-effective intervention.

Text
SCOOP Health Economics paper draft response to referees final 01_08_2018 - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (99kB)
Text
Turner_et_al-2018-Journal_of_Bone_and_Mineral_Research - Version of Record
Available under License Creative Commons Attribution.
Download (360kB)

More information

Accepted/In Press date: 23 December 2017
e-pub ahead of print date: 22 February 2018
Published date: 1 May 2018

Identifiers

Local EPrints ID: 418677
URI: https://eprints.soton.ac.uk/id/eprint/418677
ISSN: 0884-0431
PURE UUID: 2225ab2e-444c-4b76-9984-603857dc7ede
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 16 Mar 2018 17:30
Last modified: 10 Dec 2019 01:53

Export record

Altmetrics

Contributors

Author: D.A. Turner
Author: Rebekah F S Khioe
Author: Lee Shepstone
Author: Elizabeth Lenaghan
Author: Cyrus Cooper ORCID iD
Author: Neil Gittoes
Author: Nicholas Harvey ORCID iD
Author: Richard Holland
Author: Amanda Howe
Author: Eugene McCloskey
Author: Terence W O'Neill
Author: David J. Torgerson
Author: Richard Fordham

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×