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01-06-2018 | Review

Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature

Authors: C.-H. Wu, I.-J. Kao, W.-C. Hung, S.-C. Lin, H.-C. Liu, M.-H. Hsieh, S. Bagga, M. Achra, T.-T. Cheng, R.-S. Yang

Published in: Osteoporosis International | Issue 6/2018

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.

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Title: Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature
Authors: C.-H. Wu
I.-J. Kao
W.-C. Hung
S.-C. Lin
H.-C. Liu
M.-H. Hsieh
S. Bagga
M. Achra
T.-T. Cheng
R.-S. Yang
Publication date: 01-06-2018
Publisher: Springer London
Published in: Osteoporosis International / Issue 6/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-018-4411-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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