Challenge
Most post-menopausal women in Greece who have already experienced an osteoporotic fracture do not receive timely screening or treatment, and many are left vulnerable to recurring fractures and preventable complications and costs. The lack of systematic follow-up creates gaps in care pathways, hindering informed decisions regarding resource allocation and management of this high-risk group.
Ambition
This research sought to demonstrate that systematic osteoporosis screening and linkage to care (SLTC) for post-menopausal women with a prior fracture could significantly impact on future fracture burden, and provide solid evidence for policy action to close the existing gaps in treatment.
Action
Based on national data, our team built and validated a stochastic cohort model that assessed the impact of an 100% screening and linkage to care scheme according to treatment guidelines (hypothetical scenario) compared to maintaining the current management paradigm (current scenario) for this high-risk population. The model focused on measurable clinical and economic gains if the hypothetical scenario was implemented from a third-party payer perspective.
Results
Among a cohort of 50,000 post-menopausal women aged 50-74 with one prior osteoporotic fracture, the hypothetical vs the current scenario would result in:
Additionally, the hypothetical vs the current scenario would result in greater reduction in costs associated with vertebral fractures (8.1%), hip fractures (5.5%), other non-vertebral fractures (3.0%), and forearm fractures (2.5%), as well as an estimated direct incremental cost for implementing SLTC of €27.83 per woman per year in the cohort.
Impact
This study highlights the potential of increasing SLTC levels to transform public health outcomes for postmenopausal women with a prior fracture in Greece. Shifting from the current low screening rates to a comprehensive SLTC approach could prevent future suffering and disability, improve quality of life, and allow for a more optimal allocation of healthcare resources, closing gaps in care and strengthening public health.
