Sarcopenia screening strategies in older people: a cost effectiveness analysis in Iran

Abstract

Background and objectives Sarcopenia is an important age-related disease which can lead to an increased risk of mortality, falls, fractures, and poor quality of life. So, timely detection can be effective in reducing the burden of disease. The aim of this study was to identify the most cost-effective strategy for sarcopenia screening in Iran. Materials and methods We constructed a Markov transition model over a life-time horizon based on natural history. Compared strategies included Sarcopenia scoring assessment models (SarSA-Mod), European working group on sarcopenia in older people (EWGSOP), Mini sarcopenia risk assessment (MSRA) and SARC-F. Parameters values were extracted from primary data and the literature, and the costs and Quality-adjusted life years (QALYs) were calculated for each strategy. Sensitivity analysis of uncertain parameters was also performed to determine the robustness of the model. Analysis was performed using 2020 version of TreeAge Pro software. Results All four screening strategies increased life time QALYs. After removing dominated strategy, the incremental cost per QALY gained for sarcopenia screening varied from $1875.67 for EWGSOP to $1898.33 for MSRA. Our base-case analysis showed that the most cost-effective strategy was EWGSOP and 2nd best was SarSA-Mod with $43,414.3 and $42,663.3 net monetary benefits given one GDP per capita ($5520.311) as willingness to pay, respectively. Sensitivity analysis of model parameters also showed robustness of results. Conclusions The results of the study, as the first economic evaluation of sarcopenia screening, showed that the EWGSOP strategy is more cost-effective than other strategies.

SARC-F and other screening tests for sarcopenia

“…Its specificity was also reasonable (about 70%) [33]. A recent study performed in its country of origin examined the most cost-effective strategy for sarcopenia screening using four screening tools, i.e., SarSA-Mod, SARC-F, MSRA and EWGSOP1 case finding approach (usual gait speed and muscle strength) [34]. Here, SarSA-Mod was found to be the second most cost-effective tool and EWGSOP1 approach was the first one.…”

Economic Evaluation of Sarcopenia Management Interventions; a Lifetime Cost-Utility Analysis in Iran

“…Based on our knowledge, the evaluation carried out in the present study was the rst economic evaluation regarding sarcopenia management interventions so far. Previously, in general, only one economic evaluation was done in the eld of sarcopenia disease, which evaluated screening methods for this disease (40). Other economic studies have focused on the costs of disease, such as the study by In this evaluation, according to the available evidence, increasing the HRQoL, reducing the risk of falling, reducing the risk of fracture, and reducing the probability of death were considered outcomes of disease management interventions, and other possible outcomes were ignored due to the limitations of the evidence.…”

Cost-effectiveness analysis of sarcopenia management interventions in Iran

“…Based on our knowledge, the evaluation carried out in the present study was the first economic evaluation regarding sarcopenia management interventions so far. Previously, in general, only one economic evaluation was done in the field of sarcopenia disease, which evaluated screening methods for this disease [ 44 ]. Other economic studies have focused on the costs of disease, such as the study by Janssen et al (2004) and Goates et al (2019) in the United States [ 40 , 45 ] and the study by Sousa et al (2016) in Portugal [ 15 ].…”