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Costs and quality of life associated with osteoporosis-related fractures in Sweden

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Abstract

This prospective observational data collection study assessed the cost and quality of life related to hip, vertebral and wrist fracture 1 year after the fracture, based on a patient sample consisting of 635 male and female patients surviving a year after fracture. Data regarding resource use and quality of life related to fractures was collected by questionnaires at baseline, 4 months and 12 months. Information was collected by the use of patients’ records, register sources and by asking the patient. Quality of life was estimated with the EQ-5D questionnaire. Costs were estimated from a societal perspective, including direct and indirect costs. The mean fracture-related cost the year after a hip, vertebral and wrist fracture were estimated, in euros (€), at €14,221, €12,544 and €2,147, respectively [converted from Swedish krona (SEK) at an exchange rate of 9.1268 SEK/€]. The mean reduction in quality of life was estimated at 0.17, 0.26 and 0.06 for hip, vertebral and wrist fracture, respectively. Based on the results, the yearly burden of osteoporosis in Sweden could be estimated at €0.5 billion (SEK 4.6 billion). The patient sample for vertebral fracture was fairly small and included a high proportion of fractures leading to hospitalization, but they indicate a higher cost and loss of quality of life related to vertebral fracture than previously perceived.

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Notes

  1. The participating centers were: Södersjukhuset in Stockholm, Malmö University Hospital, Lund University Hospital, Norrlands University Hospital, The Hospital in Ystad, Helsingborg Hospital and Hässleholm Hospital.

  2. The following pharmaceutical categories were included: calcium and vitamin D, estrogens, bisphosphonates, glucocorticoids and pain medication.

References

  1. Osteoporos—prevention, diagnostik och behandling (2003). Stockholm

  2. Lippuner K, Golder M, Greiner R (2005) Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int 16 [Suppl 2]:S8–S17

    Article  PubMed  Google Scholar 

  3. Wong MK, Arjandas, Ching LK, Lim SL, Lo NN (2002) Osteoporotic hip fractures in Singapore—costs and patients’ outcome. Ann Acad Med Singapore 31:3–7

    PubMed  CAS  Google Scholar 

  4. Gabriel SE, Tosteson AN, Leibson CL, Crowson CS, Pond GR, Hammond CS, Melton LJ 3rd (2002) Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 13:323–330

    Article  PubMed  CAS  Google Scholar 

  5. Koeck CM, Schwappach DL, Niemann FM, Strassmann TJ, Ebner H, Klaushofer K (2001) Incidence and costs of osteoporosis-associated hip fractures in Austria. Wien Klin Wochenschr 113:371–377

    PubMed  CAS  Google Scholar 

  6. Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12:271–278

    Article  PubMed  CAS  Google Scholar 

  7. Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, Gosset C (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15:507–514

    Article  PubMed  CAS  Google Scholar 

  8. Zethraeus N, Gerdtham UG (1998) Estimating the costs of hip fracture and potential savings. Int J Technol Assess Health Care 14:255–267

    Article  PubMed  CAS  Google Scholar 

  9. Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8:611–617

    Article  PubMed  CAS  Google Scholar 

  10. Zethraeus N, Stromberg L, Jonsson B, Svensson O, Ohlen G (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68:13–17

    Article  PubMed  CAS  Google Scholar 

  11. Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15:377–386

    Article  PubMed  CAS  Google Scholar 

  12. Nurmi I, Narinen A, Luthje P, Tanninen S (2003) Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients. Arch Orthop Trauma Surg 123:551–554

    Article  PubMed  Google Scholar 

  13. Holmberg S, Thorngren KG (1988) Consumption of hospital resources for femoral neck fracture. Acta Orthop Scand 59:377–381

    PubMed  CAS  Google Scholar 

  14. Borgquist L, Lindelow G, Thorngren KG (1991) Costs of hip fracture. Rehabilitation of 180 patients in primary health care. Acta Orthop Scand 62:39–48

    PubMed  CAS  Google Scholar 

  15. Haentjens P, Autier P, Barette M, Boonen S (2001) The economic cost of hip fractures among elderly women. A one-year, prospective, observational cohort study with matched-pair analysis. Belgian Hip Fracture Study Group. J Bone Joint Surg Am 83A:493–500

    Google Scholar 

  16. De Laet CE, van Hout BA, Burger H, Weel AE, Hofman A, Pols HA (1999) Incremental cost of medical care after hip fracture and first vertebral fracture: the Rotterdam study. Osteoporos Int 10:66–72

    Article  PubMed  Google Scholar 

  17. Zethraeus N, Borgström F, Johnell O, Kanis J, Jönsson B(2002) Costs and quality of life associated with osteoporosis related fractures—results from a Swedish Survey. Stockholm School of Economics, Stockholm

  18. Statistics Sweden. Sweden’s statistical databases. http://www.scbse/eng/databaser/ssdasp

  19. Sveriges Riksbank. Average exchange rates. http://wwwd.riksbank.com. Accessed 13 May 2005

  20. Janzon M, Levin LA, Swahn E (2002) Cost-effectiveness of an invasive strategy in unstable coronary artery disease; results from the FRISC II invasive trial. The fast revascularisation during instability in coronary artery disease trial. Eur Heart J 23:31–40

    Article  PubMed  CAS  Google Scholar 

  21. Apoteket (Swedish national pharmacy). Apotekets varuregister. December 2003, Stockholm

  22. http://www.stockholm.se Stadsledningskontorets redovisningsstab. Stockholms stads budgetavräkning

  23. Region Skånes revisorer. Granskning av Skånetrafikens upphandling, 2004. http://www.skane.se/upload/Webbplatser/Revisionen/Dokument/Granskningsrapporter/RapportSkanetrafiken040304.pdf. Accessed 15 January 2005

  24. Average hourly prices in the private sector. Statistiska Centralbyån (Statistics Sweden). http://www.ssd.scb.se/databaser/makro/MainTable.asp?yp=tansss&xu=C9233001&omradekod=AM&omradetext=Arbetsmarknad&lang=1 Accessed 11 January 2005

  25. Drummond M, O’Brien B, Stoddart G, Torrance G (1997) Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford

    Google Scholar 

  26. Gold M, Siegel J, Russell L (eds) (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York

    Google Scholar 

  27. Vägverket. Vägverkets samhällsekonomiska kalkymodell. Ekonomisk teori och värderingar (1997) Vägverket (Swedish Road Authority), Stockholm

  28. Brooks R (1996) EuroQol: the current state of play. Health Policy 37:53–72

    Article  PubMed  CAS  Google Scholar 

  29. Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35:1095–1108

    Article  PubMed  CAS  Google Scholar 

  30. Burstrom K, Johannesson M, Diderichsen F (2001) Swedish population health-related quality of life results using the EQ-5D. Qual Life Res 10:621–635

    Article  PubMed  CAS  Google Scholar 

  31. Wackerly DD, Mendenhall W, Schaeffer RL (1996) Mathematical statistics with applications. Duxbury Press, Belmont

    Google Scholar 

  32. Briggs AH, Wonderling DE, Mooney CZ (1997) Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. Health Econ 6:327–340

    Article  PubMed  CAS  Google Scholar 

  33. Neter J, Kutner MH, Nachtsheim CJ, Wasserman W (1996) Applied linear statistical models. McGraw-Hill, Chicago

    Google Scholar 

  34. Gujarati DN (2003) Basic econometrics. McGraw-Hill, New York

    Google Scholar 

  35. Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C (2005) The burden of hospitalised fractures in Sweden. Osteoporos Int 16:222–228

    Article  PubMed  CAS  Google Scholar 

  36. Eurostat. purchasing power parities (PPP) and comparative price level indices for the ESA95 aggregates. http://www.epp.eurostat.cec.eu.int/portal/page?_pageid=0,1136173,0_45570701&_dad=portal&_schema=PORTAL. Accessed 31 August 2005

  37. Borgstrom F, Johnell O, Kanis JA, Oden A, Sykes D, Jonsson B (2004) Cost effectiveness of raloxifene in the treatment of osteoporosis in Sweden: an economic evaluation based on the MORE study. Pharmacoeconomics 22:1153–1165

    Article  PubMed  Google Scholar 

  38. Johnell O, Jonsson B, Jonsson L, Black D (2003) Cost effectiveness of alendronate (Fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21:305–314

    Article  PubMed  Google Scholar 

  39. Jonsson B, Christiansen C, Johnell O, Hedbrandt J (1995) Cost-effectiveness of fracture prevention in established osteoporosis. Osteoporos Int 5:136–142

    Article  PubMed  CAS  Google Scholar 

  40. Tosteson AN, Gabriel SE, Grove MR, Moncur MM, Kneeland TS, Melton LJ 3rd (2001) Impact of hip and vertebral fractures on quality adjusted life years. Osteoporos Int 12:1042–1049

    Article  PubMed  CAS  Google Scholar 

  41. Gabriel SE, Kneeland TS, Melton LJ 3rd, Moncur MM, Ettinger B, Tosteson AN (1999) Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 19:141–148

    Article  PubMed  CAS  Google Scholar 

  42. Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, Quine S (2000) Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ 320:341–346

    Article  PubMed  CAS  Google Scholar 

  43. Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13:768–776

    Article  PubMed  CAS  Google Scholar 

  44. Tidermark J, Zethraeus N, Svensson O, Tornkvist H, Ponzer S (2002) Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Qual Life Res 11:473–481

    Article  PubMed  Google Scholar 

  45. Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, Kanis J (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392

    Article  PubMed  CAS  Google Scholar 

  46. Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112

    Article  PubMed  Google Scholar 

  47. Dolan P, Torgerson D, Kakarlapudi TK (1999) Health-related quality of life of Colles’ fracture patients. Osteoporos Int 9:196–199

    Article  PubMed  CAS  Google Scholar 

  48. Henriksson F, Agardh CD, Berne C, Bolinder J, Lonnqvist F, Stenstrom P, Ostenson CG, Jonsson B (2000) Direct medical costs for patients with type 2 diabetes in Sweden. J Intern Med 248:387–396

    Article  PubMed  CAS  Google Scholar 

  49. Henriksson F, Fredrikson S, Masterman T, Jonsson B (2001) Costs, quality of life and disease severity in multiple sclerosis: a cross-sectional study in Sweden. Eur J Neurol 8:27–35

    Article  PubMed  CAS  Google Scholar 

  50. Ekman M, Zethraeus N, Dahlström U, Höglund C (2002) Är behandling av hjärtsvikt med betablockerare kostnadseffektiv? Läkartidningen 99

  51. Eichler HG, Kong SX, Gerth WC, Mavros P, Jonsson B (2004) Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge? Value Health 7:518–528

    Article  PubMed  Google Scholar 

  52. Kostnad per vårdtillfälle, vårddag och läkarbesök på sjukhus 2001. http://www.lf.se/sek/tankstation.htm, Landstingsförbundet, Stockholm

  53. Sydöstra sjukvårdsregionen, 2004 [online]. http://www.lio.se/utm/gen1.asp?ArticleId=23077. Accessed 23 December 2004

  54. Uppsala Akademiska Sjukhus, 2004 [online]. http://www.lul.se/svn/. Accessed 14 May 2004

  55. Norrlands universitetssjukhus, 2004 [online]. http://www.norrlandstingen.nu/nuspri04utg2.xls. Accessed 23 December 2004

  56. Universitetssjukhuset MAS, 2004 [online]. http://www.srvn.org/prislista.htm. Accessed 23 December 2004

  57. Universitetssjukhuset i Lund, 2004 [online]. http://www.srvn.org/prislista.htm. Accessed 23 December 2004

  58. Nyköping lasarett, 2004 [online]. http://www.lul.se/svn/. Accessed 14 May 2004

  59. Mälarsjukhuset, 2004 [online]. http://www.lul.se/svn/. Accessed 14 May 2004

  60. Huddinge Universitetssjukhus, 2004 [online]. http://www.extern.bkv.sll.se/samv.sthlm–gotland/. Accessed 10 September 2004

  61. Karolinska Univeristetssjukhuset, 2004 [online]. http://www.extern.bkv.sll.se/samv.sthlm–gotland/. Accessed 9 September 2004

  62. Västra Sjukvårdsregionen, 2004 [online]. http://www.vgregion.se/upload/svn%20–%20samverkansnämden/utomlanspriser_2004.pdf. Accessed 28 June 2004

  63. Universitetssjukhuset i írebro, 2004 [online]. http://www.lul.se/svn/. Accessed 14 May 2004

  64. Stockholms stads budgetavräkning 2003 [online]. http://www.stockholm.se/files/71600–71699/file_71645.pdf. Accessed 20 December 2004

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Acknowledgments

Financial support for this study was obtained from The Alliance for Better Bone Health. We are most grateful to the research nurses who collected the data. Without your help this study could not and cannot be conducted. Thank you: Ulla-Britt Ohlsson, Anita Söderqvist, Eva Ekström, Helen Wikdahl, Susanne Thomas and Karin Önnby.

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Correspondence to Fredrik Borgström.

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Borgström, F., Zethraeus, N., Johnell, O. et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17, 637–650 (2006). https://doi.org/10.1007/s00198-005-0015-8

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