OBJECTIVES: Chinese men with osteoporosis may be underdiagnosed and undertreated, accompanied with potential endpoint of fractures. To date, lack of evidence elucidates the cost-effectiveness of screening followed by anti-osteoporotic therapy for aged men to reduce alcohol-related fractures. This study implemented an economic evaluation to assess the screening followed preventive treatment in older male population with alcohol intake.

METHODS: A patient-level Markov model was developed to simulate the outcome of Chinese men who had excessive alcohol consumption. The quality-adjusted life-years (QALY), and lifetime cost were estimated for men who received screening for osteoporosis or osteopenia followed by preventive alendronate therapy compared with no screening strategy. Scenario analyses were conducted to evaluate the cost-effectiveness associated with risk factors, study perspectives, or drug selection of fracture treatment.

RESULTS: Among the male individuals aged 60-69 years, the number of individuals diagnosed and received preventive therapy was estimated to be 44.38% for screening for osteopenia, with a reduction of 5.03% in hip fracture and 4.72% in vertebral fracture. And the incremental cost-effectiveness ratio (ICER) was $39515.0548/QALY, which would not be preferred over no screening strategy at the willingness-to-pay threshold of $38223/QALY. However, the screening strategies would become cost-effective for older men aged over 70 years. Scenario analyses revealed screening strategies would be cost-effective in men with one or more risk factors aged over 60 years. From the societal perspective, screening for osteopenia aged from 60 years was cost-effective at the ICER of $36524.1536/QALY. In the selection of drug treatment, denosumab might be dominant compared with alendronate.

CONCLUSIONS: These findings suggest that screening and preventive therapy for Chinese men over 70 years would be cost-effective. Screening for osteopenia would be recommended for Chinese older men initialed in age 60 years in societal perspective, or with more than one risk factors in healthcare perspective.