Cost-effectiveness of opportunistic QCT-based osteoporosis screening for the prediction of incident vertebral fractures

• Verfasst von: Rühling, Sebastian [VerfasserIn]
• Verfasst von: Schwarting, Julian [VerfasserIn]
• Verfasst von: Froelich, Matthias F. [VerfasserIn]
• Verfasst von: Löffler, Maximilian T. [VerfasserIn]
• Verfasst von: Bodden, Jannis [VerfasserIn]
• Verfasst von: Hernandez Petzsche, Moritz R. [VerfasserIn]
• Verfasst von: Baum, Thomas [VerfasserIn]
• Verfasst von: Wostrack, Maria [VerfasserIn]
• Verfasst von: Aftahy, A. Kaywan [VerfasserIn]
• Verfasst von: Seifert-Klauss, Vanadin [VerfasserIn]
• Verfasst von: Sollmann, Nico [VerfasserIn]
• Verfasst von: Zimmer, Claus [VerfasserIn]
• Verfasst von: Kirschke, Jan [VerfasserIn]
• Verfasst von: Tollens, Fabian [VerfasserIn]
• Titel: Cost-effectiveness of opportunistic QCT-based osteoporosis screening for the prediction of incident vertebral fractures
• Verf.angabe: Sebastian Rühling, Julian Schwarting, Matthias F. Froelich, Maximilian T. Löffler, Jannis Bodden, Moritz R. Hernandez Petzsche, Thomas Baum, Maria Wostrack, A. Kaywan Aftahy, Vanadin Seifert-Klauss, Nico Sollmann, Claus Zimmer, Jan S. Kirschke and Fabian Tollens
• E-Jahr: 2023
• Jahr: 31 July 2023
• Umfang: 11 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 15.07.2024
• Titel Quelle: Enthalten in: Frontiers in endocrinology
• Ort Quelle: Lausanne : Frontiers Research Foundation, 2010
• Jahr Quelle: 2023
• Band/Heft Quelle: 14(2023), Seite 1-11
• ISSN Quelle: 1664-2392
• DOI: doi:10.3389/fendo.2023.1222041
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cost-effectiveness analysis
• Sach-SW: fracture prevention
• Sach-SW: opportunistic QCT
• Sach-SW: Osteoporosis
• Sach-SW: screening
• K10plus-PPN: 1895400937

Abstract

Objectives: Opportunistic quantitative computed tomography (oQCT) derived from non-dedicated routine CT has demonstrated high accuracy in diagnosing osteoporosis and predicting incident vertebral fractures (VFs). We aimed to investigate the cost-effectiveness of oQCT screening compared to dual-energy X-ray absorptiometry (DXA) as the standard of care for osteoporosis screening. Methods: Three screening strategies (“no osteoporosis screening”, “oQCT screening”, and “DXA screening”) after routine CT were simulated in a state-transition model for hypothetical cohorts of 1,000 patients (women and men aged 65 years) over a follow-up period of 5 years (base case). The primary outcomes were the cumulative costs and the quality-adjusted life years (QALYs) estimated from a U.S. health care perspective for the year 2022. Cost-effectiveness was assessed based on a willingness-to-pay (WTP) threshold of $70,249 per QALY. The secondary outcome was the number of prevented VFs. Deterministic and probabilistic sensitivity analyses were conducted to test the models’ robustness. Results: Compared to DXA screening, oQCT screening increased QALYs in both sexes (additional 2.40 per 1,000 women and 1.44 per 1,000 men) and resulted in total costs of $3,199,016 and $950,359 vs. $3,262,934 and $933,077 for women and men, respectively. As a secondary outcome, oQCT screening prevented 2.6 and 2.0 additional VFs per 1,000 women and men, respectively. In the probabilistic sensitivity analysis, oQCT screening remained cost-effective in 88.3% (women) and 90.0% (men) of iterations. Conclusion: oQCT screening is a cost-effective ancillary approach for osteoporosis screening and has the potential to prevent a substantial number of VFs if considered in daily clinical practice.