One type A service with a valid control group showed a significant decrease in re-fractures .
Types A and B services were cost-effective , although definition of cost-effectiveness varied between studies .
Fully coordinated , intensive models of care for secondary fracture prevention are more effective in improving patient outcomes than approaches involving alerts and /or education only
Most people presenting with incident osteoporotic fractures are neither assessed nor treated for osteoporosis to reduce their risk of further fractures , despite the availability of effective treatments .
We evaluated the effectiveness of published models of care for the secondary prevention of osteoporotic fractures .
Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study
Summary We evaluated the cost-effectiveness of a  fracture liaison service  prospect ively design ed to have a parallel control group treated by st and ard care . The clinical effectiveness of this service was associated with an incremental cost-effectiveness ratio versus st and ard care of Australian dollars ( AUD ) 17,291 per quality -adjusted life year ( QALY ) gained . Introduction Osteoporotic fractures are a major burden for national health services . The risk of re-fracture following an osteoporotic fracture is particularly high . In a study unique in prospect ively having a control group treated by st and ard care , we recently demonstrated that a Minimal Trauma Fracture Liaison ( MTFL ) service significantly reduces the risk of re-fracture by 80 % . Since the service involves greater use of re sources , we have now evaluated whether it is cost-effective . Methods A Markov model was developed that incorporated fracture probabilities and re source utilization data ( expressed in AUD ) obtained directly from the 4-year MTFL service clinical study . Re source utilization , local cost and mortality data and fracture-related health utility data were used to calculate QALYs with the MTFL service and st and ard care . Main outcome measures were : additional costs of the MTFL service over st and ard care , the financial savings achieved through reduced fractures and changes in QALYs associated with reduced fractures calculated over a 10-year simulation period . Costs and QALYs were discounted at 5 % annually . Sensitivity analyses quantified the effects of different assumptions of effectiveness and re source utilization associated with the MTFL service . Results The MTFL service improved QALYs by 0.089 years and led to increased costs of AUD 1,486 per patient versus st and ard care over the 10-year simulation period . The incremental cost-effectiveness ratio versus st and ard care was AUD 17,291 per QALY gained . Results were robust under all plausible assumptions . Conclusions The MTFL service is a cost-effective intervention to reduce recurrent osteoporotic fractures
One type A service with a valid control group showed a significant decrease in re-fractures .
Types A and B services were cost-effective , although definition of cost-effectiveness varied between studies .
Fully coordinated , intensive models of care for secondary fracture prevention are more effective in improving patient outcomes than approaches involving alerts and /or education only
Most people presenting with incident osteoporotic fractures are neither assessed nor treated for osteoporosis to reduce their risk of further fractures , despite the availability of effective treatments .
We evaluated the effectiveness of published models of care for the secondary prevention of osteoporotic fractures .