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A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions

This study aimed to statistically combine multiple health state utility values (HSUVs) reported in the literature for patients with osteoporosis and osteoporotic fractures. Fracture events were associated with decrements in HSUVs which differed between fracture sites. We have provided summary values for use in future health economics analyses in osteoporosis. Osteoporotic fractures have high financial and health burden. Economic evaluations on osteoporotic fracture prevention have been frequently performed in past decades. One of the challenges in the economic evaluations was to identify consistent health state utility values (HSUVs) to use for osteoporotic fracture-related conditions. The objective of this study was to determine summary measures of multiple HSUVs reported in the literature for patients with osteoporosis and osteoporotic fractures. We performed a systematic review, meta-analysis and meta-regression of published literature that reported HSUVs for osteoporotic fracture-related conditions. There were 62 studies representing 142,477 patients included. In total, 362 HSUVs were identified: 106 for pre-fracture; 89 for post-hip fracture; 130 for post-vertebral fracture and 37 for post-wrist fracture. The pooled HSUVs, using a random-effects model were 0.76 (95 % CI 0.75, 0.77, I 2 = 0.99) for pre-fracture; 0.57 (95 % CI 0.52, 0.63, I 2 = 1) for post-hip fracture; 0.59 (95 % CI 0.55, 0.62, I 2 = 0.99) for post-vertebral facture and 0.72 (95 % CI 0.67, 0.78, I 2 = 1) for post-wrist fracture. Heterogeneities were addressed through meta-regression. HSUVs immediately following hip, vertebral and wrist fractures were 0.31, 0.44 and 0.61, respectively. Patients' HSUVs improved over time following fracture events: HSUVs for the first year after hip, vertebral and wrist fractures were 0.59, 0.55 and 0.78, respectively; and 0.66, 0.66 and 0.81 for subsequent years. Fractures were associated with significant decrements in HSUVs. This study provides a standard set of HSUVs that can be used in health economic assessments in osteoporosis.


Publication title

Osteoporosis International










Menzies Institute for Medical Research


Springer-Verlag London Ltd

Place of publication

Sweetapple House Catteshall Road, Godalming, England, Surrey, Gu7 3Dj

Rights statement

Copyright 2014 Springer

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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