GP visit to discuss GP MBS results and to provide advice Resources provided in association with proposed intervention Dietary Patient supplements cost Vitamin D testing TBA 85%= $33.20 Treatment Pharmacy Private Unknown Variable** $37.38 to $5.60 to $589.17 $34.20 Costs associated Public or with a fracture private hospital Costs associated Patient with recovery from cost a fracture *eligible patients will be referred to have a DXA scan performed through their GP or other health professional in each case **although the duration of treatment per prescription varies, prescriptions usually contain sufficient medicine to treat the patient for 28 days. Proposed structure of economic evaluation This table will be finalised following the consultation, and may change depending on consultation responses and the final decision of PASC. 9 Summary of extended PICO to define research question that assessment will investigate. Patients Intervention Comparator Outcomes to be Healthcare resources assessed to be considered Initial scan in otherwise Dual energy X-ray Clinical assessment Primary effectiveness GP consultation healthy women in 50th absorptiometry (DXA) including the use of outcomes: (clinical year for bone mineral existing fracture risk Proportion of examination and Additional groups for density, and treatment assessment tools women offered use of existing consideration: (lifestyle and dietary (including vitamin D the scan who fracture risk in their 55th advice, including test) with lifestyle and receive the scan tools). year vitamin D test) for all dietary advice. Proportion of Vitamin D tests. Women in their women with negative women who Use of dietary 60th year. DXA and QCT adhere to dietary supplements. Follow-up options to be are excluded. and lifestyle Costs associated evaluated: Pharmaceutical advice with a fracture No repeat test intervention for Incidence of MTF Costs associated Repeat test for low BMD is Incidence of all with recovery initial negative excluded. fractures from a fracture test QCT is excluded. Patient-related DXA test Repeat test for all The evidence quality of life Follow-up GP (at 5 or 10 should also be Safety outcomes and consultation for years) used to adverse events: advice Exclude: determine the Any adverse Use of non-PBS All women at age best threshold for event or reimbursable 70 and over, intervention. complication anti-resorptive
GP visit to discuss results and to provide advice GP MBS Resources provided in association with proposed intervention Dietary supplements Patient cost Vitamin D testing TBA 85%= $33.20 Treatment Pharmacy Private Unknown Variable** $37.38 to $589.17 $5.60 to $34.20 Costs associated with a fracture Public or private hospital Costs associated with recovery from a fracture Patient cost *eligible patients will be referred to have a DXA scan performed through their GP or other health professional in each case **although the duration of treatment per prescription varies, prescriptions usually contain sufficient medicine to treat the patient for 28 days. Proposed structure of economic evaluation This table will be finalised following the consultation, and may change depending on consultation responses and the final decision of PASC. 9 Summary of extended PICO to define research question that assessment will investigate. Patients Intervention Comparator Outcomes to be assessed Healthcare resources to be considered Initial scan in otherwise healthy women in 50th year Additional groups for consideration: in their 55th year Women in their 60th year. Follow-up options to be evaluated: No repeat test Repeat test for initial negative test Repeat test for all (at 5 or 10 years) Exclude: All women at age 70 and over, Dual energy X-ray absorptiometry (DXA) for bone mineral density, and treatment (lifestyle and dietary advice, including vitamin D test) for all women with negative Pharmaceutical intervention for low BMD is excluded. QCT is excluded. The evidence should also be used to determine the best threshold for intervention. Clinical assessment including the use of existing fracture risk assessment tools (including vitamin D test) with lifestyle and dietary advice. DXA and QCT are excluded. Primary effectiveness outcomes: Proportion of women offered the scan who receive the scan Proportion of women who adhere to dietary and lifestyle advice Incidence of MTF Incidence of all fractures Patient-related quality of life Safety outcomes and adverse events: Any adverse event or complication GP consultation (clinical examination and use of existing fracture risk tools). Vitamin D tests. Use of dietary supplements. Costs associated with a fracture Costs associated with recovery from a fracture DXA test Follow-up GP consultation for advice Use of non-PBS reimbursable anti-resorptive
1162-BMD-FinalDAP-accessible.docx