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估算韩国女性骨质疏松症诊断和治疗改善的未来临床和经济效益:2020 年至 2040 年的模拟预测模型。

Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in South Korea: a simulation projection model from 2020 to 2040.

机构信息

BluePath Solutions, Inc., Los Angeles, CA, USA.

Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, South Korea.

出版信息

Arch Osteoporos. 2021 Jul 28;16(1):115. doi: 10.1007/s11657-021-00952-3.

Abstract

UNLABELLED

Using a microsimulation model, the impact of increased diagnosis and treatment of postmenopausal women with osteoporosis on anticipated reduction in fractures and associated costs in South Korea from 2020 to 2040 was projected.

INTRODUCTION

The economic burden of osteoporosis was US $5.1B in 2011 in South Korea. Osteoporosis is expected to strain resources in South Korea as the population most susceptible to osteoporotic fracture, females > 50 years old, is projected to increase by 32% from 2020 to 2040.

METHODS

A microsimulation model was developed to project annual incidence and costs of osteoporotic fractures among postmenopausal women from 2020 to 2040. Fracture risk was estimated using the simplified Fracture Risk Assessment Tool (FRAX). The fracture estimates were based on annualized FRAX risk and impact of treatment. Korean National Health Insurance data informed treatment and case-finding rates in the reference case. Two scenarios were evaluated: 50% increases to (i) case finding (screening rate and subsequent treatment rate) and (ii) treatment rate among those at highest risk.

RESULTS

Among individuals modeled in the reference case from 2020 to 2040, 41.2 M fractures at a cost of US $263.6B were projected. Increased treatment scenario prevented 4.4 M fractures and saved US $13.5B. Increased case-finding scenario prevented 4.0 M fractures and saved US $11.1B.

CONCLUSION

Implementation of policies to enable increasing case finding or treatment may result in fewer fractures and substantial cost savings across the healthcare system. These results highlight the importance of early screening, diagnosis, and preventive treatment.

摘要

目的

使用微观模拟模型,预测 2020 年至 2040 年韩国因增加对绝经后骨质疏松症患者的诊断和治疗而预期减少骨折数量及其相关成本。

简介

2011 年,骨质疏松症给韩国带来的经济负担为 51 亿美元。预计骨质疏松症将给韩国的医疗资源带来压力,因为最易发生骨质疏松性骨折的人群(女性>50 岁)预计将从 2020 年到 2040 年增加 32%。

方法

开发了一个微观模拟模型,以预测 2020 年至 2040 年绝经后妇女骨质疏松性骨折的年发生率和成本。使用简化骨折风险评估工具(FRAX)估计骨折风险。骨折估计数基于年化 FRAX 风险和治疗效果。韩国国家健康保险数据为参考案例中的治疗和发现病例率提供了信息。评估了两种情况:(i)发现病例(筛查率和随后的治疗率)和(ii)高危人群的治疗率增加 50%。

结果

在参考案例中,从 2020 年到 2040 年建模的个体中,预计会发生 4120 万次骨折,费用为 2636 亿美元。增加治疗方案可预防 440 万次骨折,节省 135 亿美元。增加发现病例方案可预防 400 万次骨折,节省 111 亿美元。

结论

实施政策以提高发现病例或治疗的能力可能会减少整个医疗保健系统的骨折数量并节省大量成本。这些结果强调了早期筛查、诊断和预防性治疗的重要性。

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