Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight

J. T. Schousboe, M. Gourlay, H. A. Fink, B. C. Taylor, Eric Orwoll, E. Barrett-Connor, L. J. Melton, S. R. Cummings, K. E. Ensrud

Research output: Contribution to journalArticle

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Abstract

We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. Introduction: Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. Methods: We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. Results: Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. Conclusions: For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.

Original languageEnglish (US)
Pages (from-to)163-177
Number of pages15
JournalOsteoporosis International
Volume24
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Densitometry
Cost-Benefit Analysis
Body Weight
Bone and Bones
Costs and Cost Analysis
Osteoporotic Fractures
Osteoporosis
Femoral Neck Fractures
Drug Costs
Quality-Adjusted Life Years
Nutrition Surveys
Hip Fractures
Insurance Benefits
Weights and Measures
Drug Therapy

Keywords

  • Body weight
  • Bone densitometry
  • Cost-effectiveness
  • Osteoporosis screening

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight. / Schousboe, J. T.; Gourlay, M.; Fink, H. A.; Taylor, B. C.; Orwoll, Eric; Barrett-Connor, E.; Melton, L. J.; Cummings, S. R.; Ensrud, K. E.

In: Osteoporosis International, Vol. 24, No. 1, 01.2013, p. 163-177.

Research output: Contribution to journalArticle

Schousboe, JT, Gourlay, M, Fink, HA, Taylor, BC, Orwoll, E, Barrett-Connor, E, Melton, LJ, Cummings, SR & Ensrud, KE 2013, 'Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight', Osteoporosis International, vol. 24, no. 1, pp. 163-177. https://doi.org/10.1007/s00198-012-1936-7
Schousboe, J. T. ; Gourlay, M. ; Fink, H. A. ; Taylor, B. C. ; Orwoll, Eric ; Barrett-Connor, E. ; Melton, L. J. ; Cummings, S. R. ; Ensrud, K. E. / Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight. In: Osteoporosis International. 2013 ; Vol. 24, No. 1. pp. 163-177.
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AU - Taylor, B. C.

AU - Orwoll, Eric

AU - Barrett-Connor, E.

AU - Melton, L. J.

AU - Cummings, S. R.

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N2 - We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. Introduction: Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. Methods: We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. Results: Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. Conclusions: For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.

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