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Trends in and relation between hip fracture incidence and osteoporosis medication utilization and prices in Estonia in 2004–2015

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Abstract

Summary

Osteoporosis medicines reduce osteoporotic fractures. There is a very strong negative correlation between the consumption of medicines and the price of an average daily dose indicating that affordability is a key factor that could increase consumption of antiosteoporotic medicines and, through that, reduce fractures.

Purpose

Osteoporosis is a major cause of morbidity and mortality in the modern world. Our study aims to describe the trends in incidence of hip fractures in relation to drug utilization patterns and the average price of antiosteoporotic medicines in Estonia.

Methods

Data on hip fractures was obtained from the medical claims database of Estonian Health Insurance Fund (EHIF). Consumption and price data was obtained from the Estonian State Agency of Medicines (SAM).Consumption is presented using WHO defined daily doses methodology, and the prices reflect the average wholesale price of medicines.

Results

From 2004 to 2010 there was a non-significant increasing trend in standardized hip fracture incidence in Estonia, but from 2010 to 2015, the trend turned to a significant decrease of 4.5% per year. The consumption of osteoporosis medication increased significantly from 2004 to 2009 by yearly average of 41.2%. After 2009, the consumption levelled. On contrast, the average price of one daily dose of osteoporosis medication decreased significantly from 2004 to 2009 by 16.9% per year and the decrease also levelled after 2009. This gives a very strong negative correlation of −0.93 (p < 0.001) between the consumption of antiosteoporotic medication and the average price of a daily dose of medication during the study period.

Conclusions

The statistically significant decline of standardized incidence of hip fractures from 2010 onward could at least in part be the result of the high increase in consumption of antiosteoporotic medicines which in turn is strongly negatively correlated with the average price of osteoporosis medicines.

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Authors and Affiliations

  1. Department of Traumatology and Orthopedics, University of Tartu, L. Puusepa 8, Tartu, Estonia

    Ott Laius, Katre Maasalu & Aare Märtson

  2. Estonian State Agency of Medicines, Nooruse 1, 50411, Tartu, Estonia

    Ott Laius

  3. Institute of Family Medicine and Public Health, Department of Epidemiology and Biostatistics, University of Tartu, Ravila, 19, Tartu, Estonia

    Heti Pisarev

  4. Clinic of Traumatology and Orthopaedics, Tartu University Hospital, L. Puusepa 8, Tartu, Estonia

    Katre Maasalu & Aare Märtson

  5. Institute of Biomedicine and Translational Medicine, Department of Pathophysiology, University of Tartu, Ravila, 19, Tartu, Estonia

    Sulev Kõks

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  1. Ott Laius
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Correspondence to Ott Laius.

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Funding source

This work was supported by institutional research funding IUT 20–46 of the Estonian Ministry of Education and Research.

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Laius, O., Pisarev, H., Maasalu, K. et al. Trends in and relation between hip fracture incidence and osteoporosis medication utilization and prices in Estonia in 2004–2015. Arch Osteoporos 12, 48 (2017). https://doi.org/10.1007/s11657-017-0341-4

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  • DOI: https://doi.org/10.1007/s11657-017-0341-4

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