Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study
Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study
Summary: community-based screening and treatment of women aged 70–85 years at high fracture risk reduced fractures; moreover, the screening programme was cost-saving. The results support a case for a screening programme of fracture risk in older women in the UK.
Introduction: the SCOOP (screening for prevention of fractures in older women) randomized controlled trial investigated whether community-based screening could reduce fractures in women aged 70–85 years. The objective of this study was to estimate the long-term cost-effectiveness of screening for fracture risk in a UK primary care setting compared with usual management, based on the SCOOP study.
Methods: a health economic Markov model was used to predict the life-time consequences in terms of costs and quality of life of the screening programme compared with the control arm. The model was populated with costs related to drugs, administration and screening intervention derived from the SCOOP study. Fracture risk reduction in the screening arm compared with the usual management arm was derived from SCOOP. Modelled fracture risk corresponded to the risk observed in SCOOP.
Results: screening of 1000 patients saved 9 hip fractures and 20 non-hip fractures over the remaining lifetime (mean 14 years) compared with usual management. In total, the screening arm saved costs (£286) and gained 0.015 QALYs/patient in comparison with usual management arm.
Conclusions: this analysis suggests that a screening programme of fracture risk in older women in the UK would gain quality of life and life years, and reduce fracture costs to more than offset the cost of running the programme.
Cost-effectiveness, FRAX, Fracture risk assessment, Randomized controlled trial, UK
1499-1506
Soreskog, E.
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Borgström, F.
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Shepstone, Lee
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Clarke, S.
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Cooper, Cyrus
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Harvey, I.
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Harvey, Nicholas
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Howe, A.
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Johansson, H.
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Marshall, Tarnya
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O'Neill, T.W.
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Peters, Tim J.
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redmond, niamh maria
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Turner, D.
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Holland, R
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McCloskey, Eugene
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Kanis, J.A,
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1 August 2020
Soreskog, E.
3faae4ec-67d1-449f-8a90-94dd16ee0183
Borgström, F.
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Shepstone, Lee
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Clarke, S.
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Cooper, Cyrus
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Harvey, I.
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Harvey, Nicholas
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Howe, A.
c166c6c8-2850-419b-9f97-75d17bf0886a
Johansson, H.
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Marshall, Tarnya
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O'Neill, T.W.
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Peters, Tim J.
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redmond, niamh maria
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Turner, D.
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Holland, R
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McCloskey, Eugene
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Kanis, J.A,
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Soreskog, E., Borgström, F., Shepstone, Lee, Clarke, S., Cooper, Cyrus, Harvey, I., Harvey, Nicholas, Howe, A., Johansson, H., Marshall, Tarnya, O'Neill, T.W., Peters, Tim J., redmond, niamh maria, Turner, D., Holland, R, McCloskey, Eugene and Kanis, J.A,
(2020)
Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study.
Osteoporosis International, 31 (8), .
(doi:10.1007/s00198-020-05372-6).
Abstract
Summary: community-based screening and treatment of women aged 70–85 years at high fracture risk reduced fractures; moreover, the screening programme was cost-saving. The results support a case for a screening programme of fracture risk in older women in the UK.
Introduction: the SCOOP (screening for prevention of fractures in older women) randomized controlled trial investigated whether community-based screening could reduce fractures in women aged 70–85 years. The objective of this study was to estimate the long-term cost-effectiveness of screening for fracture risk in a UK primary care setting compared with usual management, based on the SCOOP study.
Methods: a health economic Markov model was used to predict the life-time consequences in terms of costs and quality of life of the screening programme compared with the control arm. The model was populated with costs related to drugs, administration and screening intervention derived from the SCOOP study. Fracture risk reduction in the screening arm compared with the usual management arm was derived from SCOOP. Modelled fracture risk corresponded to the risk observed in SCOOP.
Results: screening of 1000 patients saved 9 hip fractures and 20 non-hip fractures over the remaining lifetime (mean 14 years) compared with usual management. In total, the screening arm saved costs (£286) and gained 0.015 QALYs/patient in comparison with usual management arm.
Conclusions: this analysis suggests that a screening programme of fracture risk in older women in the UK would gain quality of life and life years, and reduce fracture costs to more than offset the cost of running the programme.
Text
CE SCOOP v5.2 clean1310279 (003)
- Accepted Manuscript
More information
Accepted/In Press date: 28 February 2020
e-pub ahead of print date: 1 April 2020
Published date: 1 August 2020
Additional Information:
Funding Information:
Ethical approval was obtained from the North Western - Haydock Research Ethics Committee of England in September 2007 (REC 07/H1010/70). The trial was registered on the International Standard Randomized Controlled Trial Register in June 2007 (ISRCTN 55814835). The Arthritis Research United Kingdom (ARUK), formerly the Arthritis Research Campaign (ARC), and the Medical Research Council (MRC) of the UK jointly funded this trial.
Funding Information:
C Cooper has received consultancy fees and honoraria from Amgen, Danone, Eli Lilly, GlaxoSmithKline, Medtronic, Merck, Nestlé, Novartis, Pfzer, Roche, Servier, Shire, Takeda, and UCB. N Harvey has received consultancy, lecture fees, and honoraria from Alliance for Better Bone Health, Amgen, MSD, Eli Lilly, Servier, Shire, UCB, Consilient Healthcare, and Internis Pharma JA Kanis reports grants from UCB, Amgen and Radius Health outside the submitted work. E McCloskey has been, or currently is, an adviser or speaker for and has received research support from ActiveSignal, Amgen, AstraZeneca, Consilient Healthcare, GlaxoSmithKline, Hologic, Internis, Eli Lilly, Medtronic, Merck, Novartis, Pfzer, Roche, Sanof-Aventis, Servier, Synexus, Tethys, UCB, and Warner Chilcott; and has received research support from I3 Innovus, International Osteoporosis Foundation, and Unilever. E Söreskog and F Borgström have previously consulted for companies marketing products for osteoporosis. T O’Neill has received consultancy fees from UCB and research support from Amgen outside the submitted work.
Publisher Copyright:
© 2020, International Osteoporosis Foundation and National Osteoporosis Foundation.
Keywords:
Cost-effectiveness, FRAX, Fracture risk assessment, Randomized controlled trial, UK
Identifiers
Local EPrints ID: 439220
URI: http://eprints.soton.ac.uk/id/eprint/439220
ISSN: 0937-941X
PURE UUID: a850f9ba-97c0-46bc-8a45-e7c68acabdfc
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Date deposited: 07 Apr 2020 16:30
Last modified: 18 Mar 2024 05:08
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Contributors
Author:
E. Soreskog
Author:
F. Borgström
Author:
Lee Shepstone
Author:
S. Clarke
Author:
I. Harvey
Author:
A. Howe
Author:
H. Johansson
Author:
Tarnya Marshall
Author:
T.W. O'Neill
Author:
Tim J. Peters
Author:
niamh maria redmond
Author:
D. Turner
Author:
R Holland
Author:
Eugene McCloskey
Author:
J.A, Kanis
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