Advertisement

Archives of Osteoporosis

, 8:125 | Cite as

Health care costs of osteopenia, osteoporosis, and fragility fractures in Mexico

  • Fernando CarlosEmail author
  • Patricia Clark
  • Rosa María Galindo-Suárez
  • Laura Gabriela Chico-Barba
Original Article

Abstract

Summary

Different sources were used to estimate the 2010 health care costs of managing low bone density (osteopenia/osteoporosis) plus caring fragility fractures in Mexico at 411 million USD. Figures are projected to rise 42 % by 2020. Preventive and timely interventions are required to decrease the financial burden of these entities.

Introduction

Osteopenia, osteoporosis, and fragility fractures (FF) are a public health concern. The study purpose was to estimate the health care costs of these conditions in Mexico during 2010 and project them to 2015 and 2020.

Methods

Prevalence of osteopenia and osteoporosis was derived from international data. The Mexican version of FRAX® algorithm was used to assess risk for a major FF (hip, clinical spine, forearm, and proximal humerus) in osteopenic and osteoporotic population aged over 40 years. The estimates were applied to national demographic projections. Only direct medical costs composed by routine non-pharmacological management of osteopenia/osteoporosis besides the costs owing to medical care of major FF were considered into the analysis. Resource use for managing osteopenia/osteoporosis was defined from local sources (clinical practice guidelines, published literature, and expert opinion); unit costs were gathered from official lists. Costs for medical care of FF were based on diagnosis-related groups.

Results

In population aged ≥40 years, prevalence of osteopenia and osteoporosis in 2010 was 32.8 and 8 %, respectively. A total of 75,763 FF occurred that year. Costs of managing osteopenia and osteoporosis were 154.9 million USD, whereas medical costs due to FF reached 256.2 million USD. Therefore, the annual health care costs of these entities in 2010 were 411 million USD. Total costs will be 19.2 % higher in 2015, and by 2020, the figures will have increased by 41.7 %.

Conclusions

Low bone density entails substantial epidemiological and financial burden in Mexico, and their impact will grow considerably during the next years.

Keywords

Costs Osteopenia Osteoporosis Fractures Mexico 

Notes

Acknowledgments

We are grateful to Pfizer, S.A. de C.V. for their financial support of this study

Conflict of interest

This study was funded by an unrestricted grant from Pfizer, S.A. de C.V. Rosa María Galindo Suárez is employee of Pfizer, S.A. de C.V. Patricia Clark and Fernando Carlos act as advisors to and have received funding from several pharmaceutical companies involved in marketing products for treatment of osteoporosis, including Pfizer, S.A. de C.V.; Eli Lilly y Compañía de México, S.A. de C.V.; Productos Roche, S.A. de C.V.; and Novartis Farmaceutica, S.A. de C.V. Laura Gabriela Chico Barba has received honoraria from Pfizer, S.A. de C.V.

References

  1. 1.
    Anonymous (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129Google Scholar
  2. 2.
    Keen RW (2003) Burden of osteoporosis and fractures. Curr Osteoporos Rep 1(2):66–70PubMedCrossRefGoogle Scholar
  3. 3.
    Looker AC, Melton LJ 3rd, Harris TB, Borrud LG, Shepherd JA (2010) Prevalence and trends in low femur bone density among older US adults: NHANES 2005–2006 compared with NHANES III. J Bone Miner Res 25(1):64–71PubMedCrossRefGoogle Scholar
  4. 4.
    Lewiecki EM (2008) Prevention and treatment of postmenopausal osteoporosis. Obstet Gynecol Clin North Am 35:301–315PubMedCrossRefGoogle Scholar
  5. 5.
    Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521PubMedCrossRefGoogle Scholar
  6. 6.
    Vestergaard P, Rejnmark L, Mosekilde L (2009) Loss of life years after a hip fracture. Acta Orthop 80:525–530PubMedCrossRefGoogle Scholar
  7. 7.
    Peasgood T, Herrmann K, Kanis JA, Brazier JE (2009) An updated systematic review of Health State Utility Values for osteoporosis related conditions. Osteoporos Int 20:853–868PubMedCrossRefGoogle Scholar
  8. 8.
    Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRefGoogle Scholar
  9. 9.
    Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7PubMedCrossRefGoogle Scholar
  10. 10.
    Foundation NO (2008) Clinician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, DCGoogle Scholar
  11. 11.
    Becker DJ, Kilgore ML, Morrisey MA (2010) The societal burden of osteoporosis. Curr Rheumatol Rep 12:186–191PubMedCrossRefGoogle Scholar
  12. 12.
    Tarricone R (2006) Cost-of-illness analysis. What room in health economics? Health Policy 77:51–63PubMedCrossRefGoogle Scholar
  13. 13.
    Clark P, Carlos F, Vazquez-Martinez JL (2010) Epidemiology, costs and burden of osteoporosis in Mexico. Arch Osteoporos 5:9–17CrossRefGoogle Scholar
  14. 14.
    Cruz GI, Cisneros DF, Salazar PR, Tejeida LA (2002) Costos institucionales y dificultades en la atención de los pacientes con fracturas por osteoporosis. Acta Ortop Mex 16:292–295Google Scholar
  15. 15.
    Velasco-Murillo V, Navarrete-Hernández E, Pozos-Cavanzo JL, Ojeda-Mijares RI, Camacho-Rodríguez MA (2003) Fracturas en mujeres postmenopáusicas en el IMSS: frecuencia y costos de su atención hospitalaria. Gac Med Mex 139:453–458PubMedGoogle Scholar
  16. 16.
    Clark P, Carlos F, Barrera C, Guzman J, Maetzel A, Lavielle P, Ramirez E, Robinson V, Rodriguez-Cabrera R, Tamayo J, Tugwell P (2008) Direct costs of osteoporosis and hip fracture: an analysis for the Mexican healthcare system. Osteoporos Int 19:269–276PubMedCrossRefGoogle Scholar
  17. 17.
    Carlos F, Clark P, Maciel H, Tamayo JA (2009) Direct costs of osteoporosis and hip fracture: an analysis for the Mexican Social Insurance Health Care System. Salud Publica Mex 51(suppl 1):S108–S113PubMedGoogle Scholar
  18. 18.
    Consejo Nacional de Población. Proyecciones de la población de México 2005–2050. http://www.conapo.gob.mx/00cifras/5.htm
  19. 19.
    Instituto Nacional de Estadística y Geografía. Encuesta Nacional de Empleo y Seguridad Social (2009) Aguascalientes, Ags. México 2010Google Scholar
  20. 20.
    Kanis JA, on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield. University of Sheffield, UKGoogle Scholar
  21. 21.
    Kanis JA, Hans D, Cooper C, Baim S, Bilezikian JP, Binkley N, Cauley JA, Compston JE, Dawson-Hughes B, El-Hajj Fuleihan G, Johansson H, Leslie WD, Lewiecki EM, Luckey M, Oden A, Papapoulos SE, Poiana C, Rizzoli R, Wahl DA, McCloskey EV, Task Force of the FRAX Initiative (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:2395–2411PubMedCrossRefGoogle Scholar
  22. 22.
    Stevenson M, Davis S, Lloyd-Jones M, Beverley C (2007) The clinical effectiveness and cost-effectiveness of strontium ranelate for the prevention of osteoporotic fragility fractures in postmenopausal women. Health Technol Assess 11:1–134PubMedGoogle Scholar
  23. 23.
    Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Glüer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ 3rd, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046PubMedCrossRefGoogle Scholar
  24. 24.
    Briggs A, Sculpher M (1998) An introduction to Markov modelling for economic evaluation. PharmacoEconomics 13:397–409PubMedCrossRefGoogle Scholar
  25. 25.
    Ettinger B, Black DM, Dawson-Hughes B, Pressman AR, Melton LJ 3rd (2010) Updated fracture incidence rates for the US version of FRAX. Osteoporos Int 21:25–33PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Instituto Mexicano del Seguro Social. Guía de Referencia Rápida (2009) Diagnóstico y Tratamiento de la Osteoporosis en el Adulto. Instituto Mexicano del Seguro Social, Guía de Referencia Rápida, Mexico CityGoogle Scholar
  27. 27.
    Sistema de Protección Social en Salud (2005) Elementos conceptuales, económicos y operativos. En: Unidad de Análisis Económico, Primerath edn. Secretaria de Salud, México, pp 11–38Google Scholar
  28. 28.
    Instituto Mexicano del Seguro Social. Costos Unitarios de Atención Médica. Diario Oficial de la Federación. Martes 18 de mayo de 2010Google Scholar
  29. 29.
    Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Informe Financiero y Actuarial (2010) México, D.F., junio de 2010Google Scholar
  30. 30.
    Instituto Nacional de Rehabilitación (2010) Tabulador de costos de recuperación. Secretaría de Salud, MéxicoGoogle Scholar
  31. 31.
    Instituto Mexicano del Seguro Social (2008) Costos Médico-Técnicos para los Grupos Relacionados con el Diagnóstico (GRD), http://www.imss.gob.mx/profesionales/Documents/GRD_IMSS.pdf
  32. 32.
    Banco de México. Tipo de cambio FIX peso/dólar. http://www.banxico.org.mx/portal-mercado-cambiario/index.html
  33. 33.
    Mueller D, Gandjour A (2009) Cost-effectiveness of using clinical risk factors with and without DXA for osteoporosis screening in postmenopausal women. Value Health 12:1106–1117PubMedCrossRefGoogle Scholar
  34. 34.
    Instituto Nacional de Estadística y Geografía. Indicadores de demografía y población. http://www.inegi.org.mx
  35. 35.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475PubMedCrossRefGoogle Scholar
  36. 36.
    Shi N, Foley K, Lenhart G, Badamgarav E (2009) Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures. Bone 45(6):1084–1090PubMedCrossRefGoogle Scholar
  37. 37.
    Kanis JA, McCloskey EV, Johansson H, Oden A, Ström O, Borgström F (2010) Development and use of FRAX in osteoporosis. Osteoporos Int 21(Suppl 2):S407–S413PubMedCrossRefGoogle Scholar
  38. 38.
    Dilla T, Sacristán JA, Rentero ML (2007) Evaluación económica de teriparatida (forsteo®) en el tratamiento de la osteoporosis posmenopáusica. Rev Esp Econ Salud 6(1):57–64Google Scholar
  39. 39.
    Pike C, Birnbaum HG, Schiller M, Sharma H, Burge R, Edgell ET (2010) Direct and indirect costs of non-vertebral fracture patients with osteoporosis in the US. PharmacoEconomics 28(5):395–409PubMedCrossRefGoogle Scholar
  40. 40.
    Tarride JE, Hopkins RB, Leslie WD, Morin S, Adachi JD, Papaioannou A, Bessette L, Brown JP, Goeree R (2012) The burden of illness of osteoporosis in Canada. Osteoporos Int. doi: 10.1007/s00198-012-1931-z

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • Fernando Carlos
    • 1
    Email author
  • Patricia Clark
    • 2
    • 3
  • Rosa María Galindo-Suárez
    • 4
  • Laura Gabriela Chico-Barba
    • 2
    • 3
  1. 1.R A C Salud Consultores, S.A. de C.V.Mexico CityMexico
  2. 2.Clinical Epidemiology UnitHospital Infantil de México Federico GómezMexico CityMexico
  3. 3.Faculty of MedicineUniversidad Nacional Autónoma de MéxicoMexico CityMexico
  4. 4.Pfizer, S.A. de C.V., Mexico CityMexico CityMexico

Personalised recommendations