Osteoporosis International

, Volume 19, Issue 10, pp 1421–1429

Impact of compliance and persistence with bisphosphonate therapy on health care costs and utilization

  • J. A. Sunyecz
  • L. Mucha
  • O. Baser
  • C. E. Barr
  • M. M. Amonkar
Original Article

DOI: 10.1007/s00198-008-0586-2

Cite this article as:
Sunyecz, J.A., Mucha, L., Baser, O. et al. Osteoporos Int (2008) 19: 1421. doi:10.1007/s00198-008-0586-2

Abstract

Summary

The impact of persistence and compliance with bisphosphonate therapy on health care costs and utilization was examined in women newly prescribed bisphosphonates. At 3 years, women who were persistent and compliant with bisphosphonate therapy had lower total costs compared with non-persistent and non-compliant women, after controlling for relevant risk factors.

Introduction

The impact of persistence and compliance with bisphosphonate therapy on health care costs and utilization was examined in bisphosphonate-naïve women.

Methods

Two claims databases were used to identify women ≥45 years of age and who filled a new bisphosphonate prescription during 2000–2002. Persistence and compliance were evaluated over 3 years. Compliance was defined as a medication possession ratio (days of bisphosphonate supply/days of follow-up) ≥0.80; persistence was defined as no refill gaps ≥30 days. Multivariate models accounted for potential confounders.

Results

This analysis included 32,944 women (mean age, 64 years) who filled a new prescription for daily or weekly alendronate (n = 26,581) or risedronate (n = 6,363). At 3 years, 37% of women were compliant and 21% of women were persistent. Unadjusted total mean health care costs were lower for the compliant vs. non-compliant and persistent vs. non-persistent cohorts. After adjusting for potential confounders, total health care costs were reduced by 8.9% for persistent patients (p < 0.001) and 3.5% for compliant patients (p = 0.014). Persistence decreased the likelihood of inpatient admission by 47%.

Conclusion

At 3 years, women who were persistent and compliant with bisphosphonate therapy had lower total costs compared with non-persistent and non-compliant women, after controlling for relevant risk factors.

Keywords

BisphosphonatesComplianceCostOsteoporosisPersistence

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • J. A. Sunyecz
    • 1
  • L. Mucha
    • 2
  • O. Baser
    • 3
    • 6
  • C. E. Barr
    • 4
  • M. M. Amonkar
    • 5
  1. 1.Laurel Highlands Ob/Gyn, PCHopwoodUSA
  2. 2.Outcomes Research and EconometricsCambridgeUSA
  3. 3.Thomson HealthcareAnn ArborUSA
  4. 4.RocheNutleyUSA
  5. 5.GlaxoSmithKlineCollegevilleUSA
  6. 6.University of Michigan Medical SchoolAnn ArborUSA