Wu C.-H.Kao I.-J.Hung W.-C.Lin S.-C.Liu H.-C.Hsieh M.-H.Bagga S.Achra M.Cheng T.-T.RONG-SEN YANG2021-05-312021-05-3120180937-941Xhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85042191817&doi=10.1007%2fs00198-018-4411-2&partnerID=40&md5=af3bb743862f36410b298691c8746c39https://scholars.lib.ntu.edu.tw/handle/123456789/563625Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023–$28,800 US dollars (USD) in Japan to $14,513–$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. ? 2018, International Osteoporosis Foundation and National Osteoporosis Foundation.[SDGs]SDG3[SDGs]SDG5bisphosphonic acid derivative; Australia; Canada; cost benefit analysis; cost control; cost effectiveness analysis; disability-adjusted life year; economic aspect; fracture liaison service; fragility fracture; health service; hip fracture; human; Japan; life expectancy; osteoporosis; priority journal; quality adjusted life year; Review; Sweden; systematic review; Taiwan; United Kingdom; United States; wrist fracture; economics; fragility fracture; health care cost; health care delivery; organization and management; osteoporosis; secondary prevention; Cost-Benefit Analysis; Delivery of Health Care; Health Care Costs; Humans; Osteoporosis; Osteoporotic Fractures; Secondary Preventionreview10.1007/s00198-018-4411-2294601022-s2.0-85042191817