[AVBC 2025] Cost-effective Intervention Thresholds for Treating Patients with Osteopenia
Applied/Translational Research
Care Process & Redesign
Appropriate & Value-based Care Conference
Others
5 December 2025
To evaluate the cost-effectiveness of initiating oral bisphosphonate therapy at various fracture risk thresholds for. The identified cost-effective thresholds for treatment provide a value-based starting point for decision-making in local clinical.
Year Submitted: 2025
Published Date: 05 December 2025
Tags: Care Process ＆ Redesign, Applied/Translational Research, Cost Effectiveness, Quality Improvement, Qualitative Research
About this Content
Aims
To evaluate the cost-effectiveness of initiating oral bisphosphonate therapy at various fracture risk thresholds for patients aged 50-84 years in Singapore.
Background
In Singapore, pharmacological treatment of osteopenia follows the 2008 US National Osteoporosis Foundation recommended risk thresholds, which do not reflect local epidemiology and current costs.
Methods
A Markov model was developed to evaluate cost-effectiveness, utilizing a 10-year horizon and adopting the Singapore healthcare system's perspective. The model incorporated direct healthcare costs and quality-adjusted life years (QALYs).
Results
Cost-effective hip fracture intervention thresholds increased with age and plateaued after 70 years. For individuals below 70 years, treatment is likely cost-effective at the 3% HF threshold for both sexes. For those over 70 years, the recommended thresholds were set at 4% HF or 15% MOF for men, and 4% HF or 18% MOF for women.
Conclusion
The identified cost-effective thresholds for treatment provide a value-based starting point for decision-making in local clinical practice.
Lessons Learnt
The higher HF intervention thresholds for older patients should be considered in the context of local fracture epidemiology. These thresholds should serve as guidelines rather than strict cut-offs.
Keywords
Osteopenia, Cost-effectiveness, Bisphosphonates, Fracture Risk, Healthcare Costs
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | Others |
Organization(s) Involved | Ministry of Health, Singapore; National University Health System; Health Services and Systems Research, Duke-NUS |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Healthcare Administration |
Applicable Specialty or Discipline | Geriatric Medicine |
Project Lead(s) | Sonja Courtney Chua Jun Hui |
Project Member(s) | Johanan Dravium Ponniah |
Connect with this contributor!
Sonja Courtney Chua Jun Hui - chua_jun_hui@moh.gov.sg