Osteoporosis International

, Volume 17, Issue 11, pp 1645–1652

Compliance with drug therapy for postmenopausal osteoporosis

Original Article

DOI: 10.1007/s00198-006-0179-x

Cite this article as:
Weycker, D., Macarios, D., Edelsberg, J. et al. Osteoporos Int (2006) 17: 1645. doi:10.1007/s00198-006-0179-x



Patient compliance with pharmacotherapy for osteoporosis is typically poor in clinical practice; less frequent dosing with bisphosphonates may improve compliance.


Using data from 49 US health plans, we identified all women aged ≥45 years with osteoporosis who initiated therapy with a bisphosphonate, calcitonin, estrogen, or raloxifene. Compliance was examined alternatively in terms of incidence of adherence failure (medication days <80% of possible) and persistence failure (gap in therapy ≥90 days), and was compared across treatment groups using Kaplan-Meier methods and Cox proportional hazards models.


The study population included 18,822 women, 48% of whom initiated weekly bisphosphonate therapy. Overall risk of adherence failure was 47% at 3  months, 70% at 1  year, and 84% at 3  years. Risk of persistence failure was 47% at 1  year, and 77% at 3  years. In multivariate analyses, risk of adherence failure was higher for calcitonin (hazard ratio=2.7 vs weekly bisphosphonate therapy, p<0.01), but comparable for all other therapies. Relative risks of persistence failure were generally similar.


Approximately three-quarters of women who initiate osteoporosis drug therapy are non-adherent with treatment within 12  months, and almost 50% have discontinued such therapy by this time. Compliance with weekly bisphosphonate therapy is generally no better than that with osteoporosis medications requiring more frequent dosing.



Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  • D. Weycker
    • 1
  • D. Macarios
    • 2
  • J. Edelsberg
    • 1
  • G. Oster
    • 1
  1. 1.Policy Analysis Inc. (PAI), Four Davis CourtBrooklineUSA
  2. 2.Amgen, Inc., Global Health Economics and Outcomes ResearchThousand OaksUSA