Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study

Emma Soreskog*, TJ Peters, SCOOP Study Team, Alison R G Shaw, Kate M Taylor, Clare L Thomas

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

Abstract

Community-based screening and treatment of women age 70–85 years at high fracture risk reduced fractures; moreover, the screening programme of fracture risk in older women had an effect that was cost-saving. The results support a case for a screening programme of fracture risk in older women in the UK.
Purpose The SCOOP (screening for prevention of fractures in older women) randomised controlled trial investigated whether community-based screening could reduce fractures in women age 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 saved 9 hip fractures and 20 non-hip fractures over the remaining lifetime (mean 14 years) of 1,000 patients 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.
Original languageEnglish
JournalOsteoporosis International
DOIs
Publication statusPublished - 1 Apr 2020

Keywords

  • Fracture risk assessment
  • Cost-effectiveness
  • United Kingdom
  • FRAX
  • Randomized controlled trial

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