Related Experiment Video
Updated: Mar 22, 2026
An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Establishing and evaluating FRAX® probability thresholds in Taiwan
Ding-Cheng Chan1, Eugene V McCloskey2, Chirn-Bin Chang3
1Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Superintendent's Office, National Taiwan University Hospital Chu-Tong Branch, Hsinchu City, Taiwan.
This study establishes cost-effectiveness thresholds for osteoporosis fracture prevention in Taiwan using FRAX® models. These thresholds aim to optimize antiosteoporosis medication reimbursement policies for better patient outcomes.
Area of Science:
- Osteoporosis management
- Pharmacoeconomics
- Public health policy
Background:
- The Taiwanese FRAX® calculator was introduced in 2010.
- Cost-effectiveness thresholds for antiosteoporosis medications were not established in Taiwan.
- Optimizing osteoporosis treatment requires defined economic guidelines.
Purpose of the Study:
- To establish and evaluate FRAX®-based probability thresholds for osteoporosis in Taiwan.
- To inform reimbursement policies for antiosteoporosis medications.
- To improve the cost-effectiveness of fracture prevention strategies.
Main Methods:
- Developed cost-effectiveness thresholds using a Markov model and two translational approaches.
- Utilized Taiwanese data and literature for model development.
- Conducted sensitivity analysis with varying alendronate prices and tested thresholds on a clinical sample for National Health Insurance (NHI) reimbursement qualification.
Main Results:
- Markov model thresholds: Hip fracture (women 7%, men 6%); Major osteoporotic fracture (women 15%, men 12.5%).
- Translational models showed cost-effectiveness in specific age groups, expanding to nearly all groups with a 60% price reduction for branded alendronate.
- The NHI Administration model identified the highest proportion (44%) of patients qualifying for NHI reimbursement.
Conclusions:
- Established three FRAX®-based models for alendronate use in Taiwan to guide treatment strategies.
- Recommends incorporating FRAX®-based approaches into national reimbursement policies for antiosteoporosis drugs.
- Aims to enhance the efficiency and accessibility of osteoporosis care in Taiwan.
