ICUROS is the The International Costs and Utilities Related to Osteoporotic Fractures Study. It is an international patient based study investigating the costs and health effects of osteoporotic fractures.

ICUROS is endorsed by the International Osteoporosis Foundation (IOF) and supported by a consortium of sponsors including Amgen, Novartis, Wyeth, Kyphon and Servier. The study is centrally administered by the i3 innovus (formerly European Health Economics).

The fracture types included in ICUROS are hip, vertebral and wrist fractures. The patients are men and women over 50 years of age who suffers from an osteoporotic related fracture. The patient must also live in a private residence prior to the fracture.

Clinical vertebral fractures, confirmed by x-rays.

These are the most common osteoporotic fractures, which are prevalent enough to enable a large enough sample for analysis and stable results.

The patients themselves will serve as their own control by giving information on their resource use and quality of life before the fracture.

Patients who are severely cognitive impaired will not be able to participate in the study. The doctor in charge will judge whether a patient is capable of participating or not. As help, the doctor can use a Pfeiffer test, where the patient should score >3 to be eligible to participate. However, it should be noted that right after surgery, patients might score less, even though they should not be considered cognitive impaired. Therefore it is important that the doctor makes a professional judgment of the patient’s capability.

The exclusion criteria of cognitive impairment will give a somewhat skewed sample of the real population of fracture patients (especially hip fracture). However, these patients will have a difficulty to answer the CRF and the cognitively impaired are more frequently institutionalized whereas the target patients in the study comes from own living. Also, those cognitively impaired are also likely to have a higher level of resource consumption prior to the fracture indicating a lower fracture related cost. Some data shows that about 10-15% of all hip fracture patients have a MMS<7 and comes from own living. So, based on the current inclusion specification, we miss about 13% of the hip fracture patients. However, it would be interesting to also look at the cognitively impaired patients, which also can be done following a decision for each country.

The patients will be contacted by phone at follow-ups.

The patients only go to the hospital when they find a reason to. The study does not inflict any extra hospital visits on the patients.

No, since all follow-ups are made by phone and since it is a naturalistic study, no extra resource use will occur due to the study.

Please send an email to: icuros@healtheconomics.se for further information