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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
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
0937-941X
1499-1506
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.
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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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Soreskog, E.
3faae4ec-67d1-449f-8a90-94dd16ee0183
Borgström, F.
38075d38-f1fd-4a6e-9743-f4b6165c9d89
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
ce487fb4-d360-4aac-9d17-9466d6cba145
Howe, A.
c166c6c8-2850-419b-9f97-75d17bf0886a
Johansson, H.
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Marshall, Tarnya
e05f2b1e-f267-4ea4-aa81-3d841d45bd89
O'Neill, T.W.
688d84bf-f76f-4777-a3e1-65c6e5526365
Peters, Tim J.
b3ab1e07-326f-41c2-9813-f00f3b75bcf0
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), 1499-1506. (doi:10.1007/s00198-020-05372-6).

Record type: Article

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.

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CE SCOOP v5.2 clean1310279 (003) - Accepted Manuscript
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Accepted/In Press date: 28 February 2020
e-pub ahead of print date: 1 April 2020
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
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: 07 Apr 2020 16:30
Last modified: 26 Nov 2021 06:15

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Contributors

Author: E. Soreskog
Author: F. Borgström
Author: Lee Shepstone
Author: S. Clarke
Author: Cyrus Cooper ORCID iD
Author: I. Harvey
Author: Nicholas Harvey ORCID iD
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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