Secondary prevention of osteoporotic fractures in the Republic of Belarus: DALY-analysis and cost-effectiveness

Abstract

Objective. To calculate the number of lost (including healthy) years of life in patients aged 50 years and older with proximal femur fractures (PF) in the Republic of Belarus based on primary incidence data and evaluate the cost-effectiveness of the therapeutic model for the secondary prevention of osteoporotic fractures.Materials and methods. A comprehensive assessment of health losses was carried out using DALY analysis based on our own epidemiological data on the primary incidence of PF and is presented in years of life lost to due to premature mortality and the years lived with a disability. The alendronic acid (AA) prescription after a primary PF fracture was proposed for secondary prevention of PF fractures. The cost-effectiveness was calculated based on the cost of one saved (including healthy) year in relation to the national GDP per capita.Results. In the Republic of Belarus taking into account sex and age structure of the population it is expected to have a total of 2867 PF fractures in men (558 atal cases during the first year) and 7921 (2382 fatal cases) in women per year. The total number of lost (including healthy) years of life due to osteoporotic PF fractures was 8719.0 in men and 8169.9 in women. The administration of AA after PF fracture will save 1806.11 years of healthy life. The cost of one saved (incl. healthy) year was 1044.2 BYN/year for men (6.5% of GDP per capita) and 1720.1 BYN/year for women (10.8% of GDP per capita).Conclusion. Prescription of antiresorptive therapy in the form of alendronic acid to men and women aged 50 years and older after a osteoporotic PF fracture for prevention of recurrent osteoporotic fractures is highly cost-effective and can be considered when assessing the threshold of intervention in treating patients with osteoporosis in the Republic of Belarus.