Jönsson B, Christiansen C, Johnell O, Hedbrandt J, Karlsson G
Stockholm School of Economics, Sweden.
Scand J Rheumatol Suppl. 1996;103:30-8; discussion 39-40.
This study presents the results of a computer simulation model for calculating the cost-effectiveness and cost-utility of treating patients with established osteoporosis in order to reduce the risk of fractures. The results are based on Swedish data for risk of fracture and costs. The treatment intervention modelled is based on treatment of a 62-year-old woman with established osteoporosis. The cost per hip fracture avoided is 350,000 SEK, assuming a 50% reduction in the risk of fracture due to 5 years of treatment. A sensitivity analysis for changes in the cost and effectiveness of treatment, the risk of fracture and the discount rate is performed. The cost per life-year gained and the cost per quality-adjusted life-year (QALY) gained is presented to enable comparison of the cost-effectiveness of treating osteoporosis with that of other health care interventions. A comparison between treating the same woman for osteoporosis and mild hypertension shows a cost per life-year gained of 220,000 SEK and 128,000 SEK respectively. Cost per QALY gained is very similar for the two interventions: 105,000 SEK and 103,000 SEK respectively. This model provides a tool to enable clinicians, administrators and health policy makers to analyze and understand the economic aspects of a major health policy issue.
本研究展示了一个计算机模拟模型的结果，该模型用于计算治疗已确诊骨质疏松症患者以降低骨折风险的成本效益和成本效用。结果基于瑞典的骨折风险和成本数据。所模拟的治疗干预措施是基于对一名62岁已确诊骨质疏松症女性的治疗。假设经过5年治疗骨折风险降低50%，则避免每例髋部骨折的成本为350,000瑞典克朗。对治疗成本和效果、骨折风险以及贴现率的变化进行了敏感性分析。给出了每获得一个生命年的成本以及每获得一个质量调整生命年（QALY）的成本，以便能够将治疗骨质疏松症的成本效益与其他医疗保健干预措施的成本效益进行比较。对同一名女性进行骨质疏松症治疗和轻度高血压治疗的比较显示，每获得一个生命年的成本分别为220,000瑞典克朗和128,000瑞典克朗。两种干预措施每获得一个QALY的成本非常相似，分别为105,000瑞典克朗和103,000瑞典克朗。该模型提供了一种工具，使临床医生、管理人员和卫生政策制定者能够分析和理解一个重大卫生政策问题的经济方面。
