Table 4.
Cost-Utility Results
| Option | Cost/person ($CAD) | Incremental cost/person | QALYs/person | Incremental QALYs | ICURs |
|---|---|---|---|---|---|
| Women 40–64 years old (n = 363042) | |||||
| Physical activity | 4,828 | 20.7225 | Baselinea | ||
| Status quo | 4,835 | 7 | 20.71274 | −0.00976 | –b |
| OST/CAROC + physical activity | 5,524 | 689 | 20.72022 | 0.007446 | – |
| ORAI/CAROC + physical activity | 5,535 | 9 | 20.72273 | 0.00251 | – |
| SCORE/CAROC + physical activity | 5,542 | 7 | 20.723 | 0.00027 | – |
| BMD/CAROC + physical activity | 5,556 | 14 | 20.72282 | −0.00018 | – |
| OST/CAROC + vitamin D and calcium | 5,746 | 204 | 20.72308 | 0.00026 | – |
| OST/CAROC + physical activity + vitamin D and calcium | 5,775 | 29 | 20.72611 | 0.00303 | – |
| ORAI/CAROC + vitamin D and calcium | 5,778 | 3 | 20.72097 | −0.00514 | – |
| SCORE/CAROC + vitamin D and calcium | 5,780 | 2 | 20.72144 | −0.00047 | – |
| BMD/CAROC + vitamin D and calcium | 5,799 | 19 | 20.72081 | −0.0063 | – |
| SCORE/CAROC + physical activity + vitamin D and calcium | 5,804 | 5 | 20.72655 | 0.00574 | – |
| ORAI/CAROC + physical activity + vitamin D and calcium | 5,805 | 1 | 20.72584 | −0.00071 | – |
| BMD/CAROC + physical activity + vitamin D and calcium | 5,827 | 22 | 20.72672 | 0.00088 | 239,573 |
| Physical activity + vitamin D and calcium | 5,902 | 75 | 20.72576 | −0.00086 | – |
| Vitamin D and calcium | 5,906 | 4 | 20.71946 | −0,0064 | – |
| Women ≥65 years old (n = 136958) | |||||
| Physical activity | 7,319 | 11.31492 | |||
| Status quo | 7,487 | 168 | 11.29549 | −0.01943 | |
| BMD/CAROC + physical activity + vitamin D and calcium | 7,825 | 338 | 11.32407 | 0,02858 | 55,300 |
| OST/CAROC + physical activity + vitamin D and calcium | 7,931 | 106 | 11.31566 | −0.00841 | – |
| SCORE/CAROC + physical activity + vitamin D and calcium | 7,958 | 27 | 11.31702 | 0.00136 | – |
| ORAI/CAROC + physical activity + vitamin D and calcium | 7,967 | 9 | 11.31813 | 0.00111 | – |
| Physical activity + vitamin D and calcium | 7,979 | 12 | 11.3193 | 0.00117 | – |
| OST/CAROC + vitamin D and calcium | 8,065 | 86 | 11.30823 | −0.01107 | – |
| Vitamin D and calcium | 8,084 | 19 | 11.30893 | 0.0.0007 | – |
| SCORE/CAROC + vitamin D and calcium | 8,102 | 18 | 11.30711 | −0.00182 | – |
| ORAI/CAROC + vitamin D and calcium | 8,108 | 6 | 11.31093 | 0.00382 | – |
| BMD/CAROC + vitamin D and calcium | 8,117 | 9 | 11.30714 | −0.00379 | – |
| OST/CAROC + physical activity | 8,188 | 71 | 11.31116 | 0.00402 | – |
| ORAI/CAROC + physical activity | 8,190 | 2 | 11.31085 | −0.00031 | – |
| SCORE/CAROC + physical activity | 8,191 | 1 | 11.31238 | 0.00153 | – |
| BMD/CAROC + physical activity | 8,198 | 7 | 11.31195 | −0.00043 | – |
$CAD = Canadian dollars; QALY = quality-adjusted life-year; ICUR = incremental cost-utility ratio; OST = Osteoporosis Self-Assessment Tool; CAROC = Canadian Association of Radiologists and Osteoporosis Canada; ORAI = Osteoporosis Risk Assessment Instrument; SCORE = Simple Calculated Osteoporosis Risk Estimation; BMD = bone mineral density.
a
Less expensive strategy.
b
Dominated strategies are those that were found to be less efficacious and more expensive than another strategy (strict dominance) or to have an incremental cost-effectiveness ratio that is greater than that of the next, more effective, and more expensive alternative (extended dominance).