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评估改善日本女性骨质疏松症诊断与治疗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 Japan: a simulation projection model from 2020 to 2040.

作者信息

Hagino Hiroshi, Jackson Micah, Gitlin Matthew, Wessler Zachary

机构信息

Faculty of Medicine, Tottori University, Tottori, Japan.

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

出版信息

Arch Osteoporos. 2021 Oct 12;16(1):156. doi: 10.1007/s11657-021-01019-z.

Abstract

UNLABELLED

Impact of increased osteoporosis diagnosis and treatment among postmenopausal women (PMW) on reduction in fractures and associated costs in Japan from 2020 to 2040 was modeled.

INTRODUCTION

Japan is currently home to the world's oldest population and the 65 + years demographic is expected to grow to 35% by 2040. Thus, identifying strategies to reduce clinical and economic burden associated with osteoporosis among this at-risk population is critical.

METHODS

A microsimulation model was developed to project osteoporotic annual fracture incidence and costs among PMW 2020-2040. Fracture risk was estimated using a simplified Fracture Risk Assessment Tool (FRAX). Fracture estimates were based on annualized FRAX risk and treatment impact. Published literature informed inputs for direct and indirect fracture costs, DXA screening costs, and treatment costs and efficacy. Japan's current screening and treatment rates were compared against 50% increases to (1) case finding (screening rate and subsequent treatment rate) and (2) treatment rate among those at highest fracture risk.

RESULTS

From 2020 to 2040, 21.6 million fractures are projected costing US $410.2 billion. Increased case finding scenario resulted in the prevention of 456.9 thousand primary and 340.9 thousand second + fractures saving US $4.25 billion. Increased treatment scenario led to 500.5 thousand and 435.5 thousand fewer primary and second + fractures, respectively, and reduced economic burden by $3.1 billion.

CONCLUSION

Improvements to rates of osteoporosis screening and preventive treatment in Japan's aging population through disease awareness campaigns and post-fracture care programs, among others, will likely reduce osteoporosis-associated clinical and economic burden.

摘要

未标注

对日本绝经后女性(PMW)中骨质疏松症诊断和治疗增加对2020年至2040年骨折减少及相关成本的影响进行了建模。

引言

日本目前是世界上老年人口最多的国家,预计到2040年65岁及以上人口将增长到35%。因此,确定降低这一高危人群中与骨质疏松症相关的临床和经济负担的策略至关重要。

方法

开发了一个微观模拟模型,以预测2020年至2040年PMW中骨质疏松性年度骨折发生率和成本。使用简化的骨折风险评估工具(FRAX)估计骨折风险。骨折估计基于年化FRAX风险和治疗影响。已发表的文献为直接和间接骨折成本、双能X线吸收法(DXA)筛查成本以及治疗成本和疗效提供了数据输入。将日本目前的筛查和治疗率与提高50%后的情况进行比较,包括(1)病例发现(筛查率及后续治疗率)和(2)骨折风险最高人群的治疗率。

结果

从2020年到2040年,预计将发生2160万例骨折,成本为4102亿美元。增加病例发现的方案可预防45.69万例原发性骨折和34.09万例二次及以上骨折,节省42.5亿美元。增加治疗的方案分别减少了50.05万例和43.55万例原发性和二次及以上骨折,并减轻了31亿美元的经济负担。

结论

通过开展疾病宣传活动和骨折后护理计划等,提高日本老年人口中骨质疏松症的筛查率和预防性治疗率,可能会减轻与骨质疏松症相关的临床和经济负担。

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