Economic burden of osteoporotic fractures in Austria
Osteoporotic fractures impose a huge economic burden on society. Though several cost of illness studies from other countries exist, no equivalent study has been conducted in Austria. Our study aims at assessing costs resulting from osteoporotic fractures in Austria in the year 2008 from a societal perspective.
We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria.
For the year 2008, the total annual financial burden incurred by osteoporotic fractures in Austria amounted to approx. €685.2 million, the largest fraction of which was due to the opportunity cost of family care (30.2%), followed by costs for hospitalization (26.6%).
The financial burden of osteoporotic fractures in Austria is substantial. Our findings may have implications for future economic analyses, and also support health care authorities in their decision making.
- Consensus development conference: prophylaxis and treatment of osteoporosis Am J Med 1991,90(1):107–10.
- Johnell O, Kanis J: Epidemiology of osteoporotic fractures. Osteoporos Int 2005,16(2):S3–7. CrossRef
- Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al.: Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 2011,22(5):1277–88. CrossRef
- Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006,17(12):1726–33. CrossRef
- Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002,359(9319):1761–7. CrossRef
- Ben Sedrine W, Radican L, Reginster JY: On conducting burden-of-osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center. Rheumatology (Oxford) 2001,40(1):7–14. CrossRef
- Lippuner K, Golder M, Greiner R: Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int 2005,16(Suppl 2):S8–17. CrossRef
- Gabriel SE, Tosteson ANA, Leibson CL, Crowson CS, Pond GR, Hammond CS, et al.: Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 2002,13(4):323–30. CrossRef
- Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E: Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 2001,12(4):271–8. CrossRef
- Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, et al.: Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 1999,15(5):507–14. CrossRef
- Brecht J, Schdlich P: Burden of illness imposed by osteoporosis in Germany. HEPAC Health Economics in Prevention and Care 2000,1(1):26. CrossRef
- Häussler B, Gothe H, Göl D, Glaeske G, Pientka L, Felsenberg D: Epidemiology, treatment and costs of osteoporosis in Germany–the BoneEVA Study. Osteoporos Int 2007,18(1):77–84. CrossRef
- Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, et al.: Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 2011,22(2):685–92. CrossRef
- Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL: Methods for the Economic Evaluation of Health Care Programs. 3rd edition. Oxford University Press, Oxford; 2005.
- Johannesson M, Karlsson G: The friction cost method: a comment. J Health Econ 1997,16(2):249–55. CrossRef
- Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B: Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 2004,15(2):108–12. CrossRef
- Garraway WM, Stauffer RN, Kurland LT, O'Fallon WM: Limb fractures in a defined population.II. Orthopedic treatment and utilization of health care. Mayo Clin Proc 1979,54(11):708–13.
- Arden N, Cooper Meunier P, future of osteoporosis: Epidemiology. Osteoporosis 1998.
- Neill D, Hughes D, Leake A, Morris C, Jones D, Oakley A, et al.: Neuritogenic-neurotoxic effects of membrane-associated forms of amyloid precursor protein. Dement Geriatr Cogn Disord 2001,12(1):40–51. CrossRef
- Palvanen M, Kannus P, Niemi S, Parkkari J: Hospital-treated minimal-trauma rib fractures in elderly Finns: long-term trends and projections for the future. Osteoporos Int 2004,15(8):649–53. CrossRef
- Palvanen M, Kannus P, Niemi S, Parkkari J, Vuori I: Epidemiology of minimal trauma rib fractures in the elderly. Calcif Tissue Int 1998,62(3):274–7. CrossRef
- Erstattungskodex-EKO. 1030th edition. Hauptverband der österreichischen Sozialversicherungsträger, Wien; 2008.
- Statistik Austria: Arbeitskostenerhebungen 2008. Statistik Austria; 2008.
- Miller RE, Blair PB: Input–output Analysis. Foundations and Extentions. Cambridge University Press, New York; 2010.
- Obermayer U, Mayer-Schulz M, Stefanits J: Invaliditätspensionen. In Sozialbericht 2007 – 2008 - Ressortaktivitäten und sozialpolitische Analysen. Bundesministerium für Soziales und Konsumentenschutz, Vienna; 2008.
- Borgström F, Sobocki P, Ström O, Jönsson B: The societal burden of osteoporosis in Sweden. Bone 2007,40(6):1602–9. CrossRef
- Borgström F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, et al.: Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006,17(5):637–50. CrossRef
- Pike MM, Barnes MA, Barron RW: The role of illustrations in children's inferential comprehension. J Exp Child Psychol 2010,105(3):243–55. CrossRef
- Bouza C, López T, Palma M, Amate JM: Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 2007,18(5):649–57. CrossRef
- Zethraeus N, Strömberg L, Jönsson B, Svensson O, Ohlén G: The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 1997,68(1):13–7. CrossRef
- Johnell O, Gullberg B, Kanis JA: The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 1997,7(2):138–44. CrossRef
- Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C: The burden of hospitalised fractures in Sweden. Osteoporos Int 2005,16(2):222–8. CrossRef
- Cooper C, Campion G, Melton LJ: Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992,2(6):285–9. CrossRef
- Riggs BL, Hartmann LC: Selective estrogen-receptor modulators – mechanisms of action and application to clinical practice. N Engl J Med 2003,348(7):618–29. CrossRef
- Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al.: Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009,361(8):756–65. CrossRef
- Dimai HP, Pietschmann P, Resch H, Preisinger E, Fahrleitner-Pammer A, Dobnig H, et al.: Austrian guidance for the pharmacological treatment of osteoporosis in postmenopausal women–update 2009. Wien Med Wochenschr Suppl 2009, 122:1–34. CrossRef
- Seeman E, Compston J, Adachi J, Brandi ML, Cooper C, Dawson-Hughes B, et al.: Non-compliance: the Achilles' heel of anti-fracture efficacy. Osteoporos Int 2007,18(6):711–9. CrossRef
- Silverman SL, Gold DT, Cramer JA: Reduced fracture rates observed only in patients with proper persistence and compliance with bisphosphonate therapies. South Med J 2007,100(12):1214–8. CrossRef
- Reginster J: Adherence and persistence: impact on outcomes and health care resources. Bone 2006,38(2 Suppl 2):S18–21. CrossRef
- Pietschmann P, Azizi-Semrad U, Pils K, Fahrleitner-Pammer A, Resch H, Dobnig H: Pharmacologic undertreatment of osteoporosis in Austrian nursing homes and senior's residences. Wien Klin Wochenschr 2010,122(17–18):532–7. CrossRef
- Economic burden of osteoporotic fractures in Austria
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Health Economics Review
- Online Date
- June 2012
- Online ISSN
- Additional Links
- Burden of illness
- Costs of illness
- Author Affiliations
- 1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
- 2. Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
- 3. Association for the Promotion of Continuing Medical Education and Research, Vienna, Austria
- 4. I3 Innovus, Stockholm, Sweden
- 5. Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- 6. Department for Public Health and Health Technology Assessment, UMIT–University for Health Sciences. Medical Informatics and Technology, Hall i.T, Austria
- 7. Department of Economics, Faculty of Business, Economics and Statistics, University of Vienna, Vienna, Austria