Table 2.
Base Case Results for Annual Savings and QALY Gained Due to Averted Hip Fractures, and Effects of Changing the Sex-Specific Level of Fracture Risk for the Patient Pool
| Women (n = 1000) | Men (n = 1000) | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Population risk of hip fracture | Test | Savings ($1000) | Hip fracture averted | QALY gained | Breakeven BCT cost ($) | Savings ($1000) | Hip fracture averted | QALY gained | Breakeven BCT cost ($) |
| Base case | BCT | 200 | 5.5 | 4.06 | 7 | 2.0 | 1.56 | ||
| UC | 88 | 2.4 | 1.11 | 1 | 0.2 | 0.08 | |||
| BCT-UC | 113 | 3.1 | 2.95 | 225 | 7 | 1.9 | 1.48 | 107 | |
| 2× higher | BCT | 522 | 11.0 | 8.11 | 129 | 4.1 | 3.13 | ||
| UC | 213 | 4.6 | 2.16 | 10 | 0.3 | 0.16 | |||
| BCT-UC | 310 | 6.4 | 5.95 | 444 | 118 | 3.8 | 2.97 | 232 | |
| 3× higher | BCT | 843 | 16.4 | 12.1 | 251 | 6.2 | 4.71 | ||
| UC | 328 | 6.6 | 3.15 | 19 | 0.5 | 0.23 | |||
| BCT-UC | 515 | 9.8 | 8.99 | 672 | 233 | 5.7 | 4.48 | 359 | |
| 4× higher | BCT | 1159 | 21.8 | 16.1 | 376 | 8.3 | 6.30 | ||
| UC | 435 | 8.5 | 4.1 | 28 | 0.7 | 0.31 | |||
| BCT-UC | 724 | 13.4 | 12.0 | 904 | 348 | 7.7 | 5.99 | 487 | |
Results are cumulative per 1000 patients, are annually recurring, and are shown for the proposed BCT program relative to no screening (BCT), usual care relative to no screening (Usual care), and BCT relative to usual care (BCT-UC). The breakeven BCT cost is the average fee per BCT test that would result in the BCT program being cost neutral compared to usual care. In a one-way sensitivity analysis, data are also shown for 2×, 3×, and 4× higher levels of fracture risk. Base case hip fracture rates (annual incidence) are 10.51 per 1000 women and 4.57 per 1000 men. See main text for all assumptions.
BCT = biomechanical computed tomography; UC = usual care.