1. Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature.
- Author
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Wu, C.-H., Kao, I.-J., Liu, H.-C., Hung, W.-C., Lin, S.-C., Hsieh, M.-H., Bagga, S., Achra, M., Cheng, T.-T., and Yang, R.-S.
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OSTEOPOROSIS prevention , *WRIST injuries , *PREVENTIVE health services , *HIP joint injuries , *BONE fracture prevention , *COST control , *COST effectiveness , *INFORMATION storage & retrieval systems , *MEDICAL databases , *MEDICAL information storage & retrieval systems , *INTERPROFESSIONAL relations , *MEDICAL care costs , *MEDLINE , *ONLINE information services , *POSTAL service , *TELEMEDICINE , *SYSTEMATIC reviews , *HUMAN services programs , *PREVENTION , *ECONOMICS - Abstract
Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023-$28,800 US dollars (USD) in Japan to $14,513-$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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