Osteoporosis International

, Volume 24, Issue 1, pp 163–177

Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight

  • J. T. Schousboe
  • M. Gourlay
  • H. A. Fink
  • B. C. Taylor
  • E. S. Orwoll
  • E. Barrett-Connor
  • L. J. MeltonIII
  • S. R. Cummings
  • K. E. Ensrud
  • For the Osteoporotic Fractures in Men (MrOS) and Study of Osteoporotic Fractures (SOF) Research Groups
Original Article

DOI: 10.1007/s00198-012-1936-7

Cite this article as:
Schousboe, J.T., Gourlay, M., Fink, H.A. et al. Osteoporos Int (2013) 24: 163. doi:10.1007/s00198-012-1936-7

Abstract

Summary

We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55–65 years and men aged 55–75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective.

Introduction

Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years.

Methods

We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ −2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005–2006.

Results

Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years.

Conclusions

For women aged 55–65 years and men aged 55–75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.

Keywords

Body weightBone densitometryCost-effectivenessOsteoporosis screening

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • J. T. Schousboe
    • 1
    • 2
  • M. Gourlay
    • 3
  • H. A. Fink
    • 4
    • 5
  • B. C. Taylor
    • 5
    • 6
    • 7
  • E. S. Orwoll
    • 8
  • E. Barrett-Connor
    • 9
  • L. J. MeltonIII
    • 10
  • S. R. Cummings
    • 11
    • 12
  • K. E. Ensrud
    • 5
    • 6
    • 7
  • For the Osteoporotic Fractures in Men (MrOS) and Study of Osteoporotic Fractures (SOF) Research Groups
  1. 1.Park Nicollet InstituteMinneapolisUSA
  2. 2.Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisUSA
  3. 3.Department of Family MedicineUniversity of North CarolinaChapel HillUSA
  4. 4.Geriatric Education and Research CenterDepartment of Veterans Affairs Health Care SystemMinneapolisUSA
  5. 5.Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisUSA
  6. 6.Center for Chronic Diseases Outcomes ResearchDepartment of Veterans Affairs Health Care SystemMinneapolisUSA
  7. 7.Department of MedicineUniversity of MinnesotaMinneapolisUSA
  8. 8.Department of MedicineOregon Health Sciences UniversityPortlandUSA
  9. 9.University of California, San DiegoLa JollaUSA
  10. 10.Division of EpidemiologyMayo ClinicRochesterUSA
  11. 11.San Francisco Coordinating CenterSan FranciscoUSA
  12. 12.California Pacific Medical Center Research InstituteSan FranciscoUSA