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.

中文翻译：

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SCOOP研究在英国初级保健机构中筛查骨折风险的长期成本效益

概要

以社区为基础的筛查和治疗高骨折风险的70-85岁女性减少了骨折的发生；此外，筛选程序节省了成本。结果支持了英国老年女性骨折风险筛查计划的案例。

介绍

SCOOP（预防老年妇女骨折的筛查）随机对照试验研究了以社区为基础的筛查是否可以减少70-85岁女性的骨折。这项研究的目的是，根据SCOOP研究，与常规治疗相比，评估英国初级保健机构筛查骨折风险的长期成本效益。

方法

使用健康经济马尔可夫模型预测筛查程序的成本和生活质量（与对照组相比）对生命周期的影响。该模型由SCOOP研究得出的与药物，管理和筛查干预相关的费用组成。与常规治疗组相比，筛查组骨折风险的降低源自SCOOP。建模的骨折风险与SCOOP中观察到的风险相对应。

结果

与常规治疗相比，在剩余的生命周期（平均14年）中，对1000例患者进行了筛查，挽救了9例髋部骨折和20例非髋部骨折。与常规管理部门相比，筛查部门总共节省了成本（286英镑），每位患者获得0.015 QALYs。

结论

这项分析表明，英国老年妇女的骨折风险筛查计划将提高生活质量和寿命，并降低骨折成本，以远远超过运行该计划的成本。