{
  "abstract": "Objectives: Fractures due to bone fragility are a major cause of morbidity and mortality. This study aimed to assess the cost-effectiveness of secondary prevention of these fractures using real-world data from the Basque population.\n\nMethods: A retrospective observational study was conducted, including individuals aged 60 years and over with fragility fractures of the wrist, humerus or vertebrae. The study used a cost-effectiveness design, incorporating individual-level data on costs and quality-adjusted life years (QALYs). The two groups were balanced using a propensity score (entropy balance). Both the study follow-up period and the patient’s entire lifetime were analysed. The latter was obtained by adding comorbidity-adjusted life expectancy to the follow-up period via extrapolation based on survival analysis. The incremental cost-effectiveness ratio (ICER) was calculated for each group, and variability was analysed using bootstrapping, cost-effectiveness plots and acceptability curves. The incremental net benefit was also calculated using regression models.\n\nResults: A total of 33,569 patients were included in the study, of whom 12,833 had wrist fractures, 12,586 had vertebral fractures and 8,150 had fractures of the humerus. Of these patients, 20.12% were treated, with different percentages for vertebral (32.34%), wrist (14.46%) and humerus (10.17%) cases. The incremental cost-effectiveness ratio following the use of the propensity score was €720 per QALY gained over the follow-up period, and €270 per QALY gained when extrapolated. Similar results were obtained from the bootstrapping and incremental net benefit analyses.\n\nDiscussion: The ICER for the three types of fracture analysed is well below Spain’s defined acceptability threshold of around €23,000/QALY. This implies that secondary prevention should continue as a public health policy, with efforts being made to increase the proportion of patients treated.\n\nKey messages: • Secondary prevention of fragility fractures is a cost-effective public health policy.\n\n• More effort should be made to increase the proportion of patients who are treated.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "J Mar"
    },
    {
      "name": "O Ibarrondo"
    },
    {
      "name": "I Etxebarria-Foronda"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c0kwk4wwhmkw9.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.1077",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698309/",
  "id": "c0kwk4wwhmkw9",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.1077",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6. Poster Displays"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "heading",
      "DB. Chronic diseases, multimorbidity and non-communicable diseases"
    ],
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7223656549",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13698309/pdf/?tool=EBI",
  "pmcid": "PMC13698309",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/c0kwk4wwhmkw9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:13Z",
      "native_id": "PMC13698309",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.1077"
    },
    {
      "first_seen": "2026-10-30T12:21:25Z",
      "native_id": "PMC:PMC13698309",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13698309"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Cost-utility of drug treatment in the secondary prevention of fragility fractures: a regional study",
  "title_text": "Cost-utility of drug treatment in the secondary prevention of fragility fractures: a regional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:12Z",
  "url": "https://research.draconitic.com/paper/c0kwk4wwhmkw9",
  "venue": "The European Journal of Public Health",
  "versions": []
}