[Cost-effectiveness analysis of fracture liaison services in Catalonia].

Autor:	Surís X; Departament de Salut, Pla director de les malalties reumàtiques i de l'aparell locomotor, Barcelona, España; Servicio de Reumatología, Hospital General de Granollers, Barcelona, España; Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España. Electronic address: xsuris_ext@gencat.cat., Pueyo-Sánchez MJ; Àrea Integral de Salut Barcelona Esquerra, Consorci Sanitari de Barcelona, Regió Sanitària Barcelona, Servei Català de la Salut, Barcelona, España., Ricart A; Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España., Naranjo A; Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrin, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España., Casanova T; Servicio de Medicina Interna, Complex Hospitalari Moisès Broggi, Sant Joan Despí, Barcelona, España., Gómez-Vaquero C; Servicio de Reumatología, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España., Duaso E; Servicio de Geriatría, Atención Paliativa, Dependencia y Discapacidad, Hospital Universitari d'Igualada (Consorci Sanitari de l'Anoia), Barcelona, España., Cancio-Trujillo JM; Servicio de Geriatría y Cuidados Paliativos de Badalona Serveis Assistencials (BSA), Barcelona, España; Escuela Superior de Salud de Tecnocampus, Universidad Pompeu Fabra, Barcelona, España., Sánchez-Martín J; Market Access Area, Pharmalex Spain, Barcelona, España., Pérez-Mitru A; Market Access Area, Pharmalex Spain, Barcelona, España.
Jazyk:	Spanish; Castilian
Zdroj:	Journal of healthcare quality research [J Healthc Qual Res] 2024 Jul-Aug; Vol. 39 (4), pp. 205-213. Date of Electronic Publication: 2024 Apr 12.
DOI:	10.1016/j.jhqr.2024.03.004
Abstrakt:	Objective: To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service. Methods: Cost-utility assessment through a Markov model that simulated disease progression of a patients' cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses. Results: Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case. Conclusions: The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective. (Copyright © 2024 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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