Applied Health Economics and Health Policy

, Volume 10, Issue 3, pp 163–173

Direct healthcare costs of osteoporosis-related fractures in managed care patients receiving pharmacological osteoporosis therapy

  • Hema N. Viswanathan
  • Jeffrey R. Curtis
  • Jingbo Yu
  • Jeffrey White
  • Bradley S. Stolshek
  • Claire Merinar
  • Akhila Balasubramanian
  • Joel D. Kallich
  • John L. Adams
  • Sally W. Wade
Original Research Article

DOI: 10.2165/11598590-000000000-00000

Cite this article as:
Viswanathan, H.N., Curtis, J.R., Yu, J. et al. Appl Health Econ Health Policy (2012) 10: 163. doi:10.2165/11598590-000000000-00000

Abstract

Background

Osteoporosis is a common condition and the economic burden of osteoporosis-related fractures is significant. While studies have reported the incremental or attributable costs of osteoporosis-related fracture, data on the economic impact of osteoporosis-related fractures in commercial health plan populations are limited.

Objective

To estimate the direct costs of osteoporosis-related fractures among pharmacologically treated patients in a large, commercially insured population between 2005 and 2008.

Methods

In this retrospective cohort study, patients were identified from a large, commercially insured population with integrated pharmacy and medical claims. Inclusion criteria were age 45–64 years; one or more osteoporosis medication claim(s) with first (index) claim between 1 January 2005 and 30 April 2008; and continuous insurance coverage for ≥12 months pre-index and ≥6 months post-index. Patients with pre-index Paget’s disease or malignant neoplasm; skilled nursing facility stay; combination therapy at index; or fracture ≤6 months post-index were excluded. A generalized linear model compared differences in 6-month pre-/post-event costs for patients with and without fracture. Propensity score weighting was used to ensure comparability of fracture and non-fracture patients. Generalized estimating equations accounted for repeated measures.

Results

The study included 49 680 patients (2613 with fracture) with a mean (SD) age of 56.4 (4.7) years; 95.9% were female. Mean differences between pre- and post-event direct costs were $US14049 (95% CI 7670, 20 428) for patients with vertebral fractures, $US16 663 (95% CI 11690, 21636) for patients with hip fractures, and $US7582 (95% CI 6532, 8632) for patients with other fractures. After adjusting for covariates, osteoporosis-related fractures were associated with an additional $US9996 (95% CI 8838, 11154; p< 0.0001) in direct costs per patient across all fracture types during the 6 months following fracture.

Conclusion

Patients with osteoporosis-related fractures were found to incur nearly $US10 000 in estimated additional direct healthcare costs in the 6 months post-fracture, compared with patients with no fracture. Reduced fracture risk may lower associated direct healthcare costs.

Copyright information

© Springer International Publishing AG 2012

Authors and Affiliations

  • Hema N. Viswanathan
    • 1
    • 7
  • Jeffrey R. Curtis
    • 2
  • Jingbo Yu
    • 3
  • Jeffrey White
    • 4
  • Bradley S. Stolshek
    • 1
  • Claire Merinar
    • 1
  • Akhila Balasubramanian
    • 1
  • Joel D. Kallich
    • 1
  • John L. Adams
    • 5
  • Sally W. Wade
    • 6
  1. 1.Amgen Inc.Thousand OaksUSA
  2. 2.University of Alabama at BirminghamBirminghamUSA
  3. 3.HealthCore, Inc.WilmingtonUSA
  4. 4.WellPoint Inc.Thousand OaksUSA
  5. 5.RAND Corp.Santa MonicaUSA
  6. 6.Wade Outcomes Research and ConsultingSalt Lake CityUSA
  7. 7.One Amgen Center DriveThousand OaksUSA