Cost-effective osteoporosis treatment thresholds in Greece

Area of Science:

• Health Economics
• Osteoporosis Management
• Public Health Policy

Background:

• Osteoporosis poses a significant public health challenge globally and in Greece.
• Identifying cost-effective intervention strategies is crucial for optimizing healthcare resource allocation.
• The FRAX tool provides fracture risk assessment, but its application for cost-effectiveness requires local calibration.

Purpose of the Study:

• To determine the fracture probability thresholds for cost-effective osteoporosis treatment in Greece.
• To adapt the FRAX (Fracture Risk Assessment Tool) algorithm for Greek healthcare economic evaluations.
• To establish age- and risk-stratified intervention guidelines based on cost-effectiveness.

Main Methods:

• A Greek-specific Markov cohort model was developed.
• Quality-Adjusted Life Years (QALYs) were utilized to assess cost-effectiveness.
• Intervention cost-effectiveness thresholds were calculated based on a willingness to pay of €30,000 per QALY gained.

Main Results:

• A biphasic intervention threshold model was identified.
• For individuals under 75, cost-effective treatment is indicated at 10-year hip fracture probability of ≥2.5% and major osteoporotic fracture probability of ≥10%.
• For individuals 75 and older, thresholds increase to ≥5% for hip and ≥15% for major osteoporotic fractures.

Conclusions:

• The FRAX algorithm can effectively identify candidates for cost-effective osteoporosis treatment in Greece.
• Implementing these age- and risk-stratified thresholds can optimize treatment decisions and resource allocation.
• This study provides evidence-based guidance for osteoporosis management in the Greek healthcare setting.