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Understanding the long-term impact of incident osteoporotic fractures on healthcare utilization and costs in Korean postmenopausal women

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Abstract

Summary

This study provides long-term evidence that healthcare resource utilization and costs of care in women who experienced incident osteoporotic fractures remained higher than those in women without fractures over a span of 5 years. These findings emphasize the importance of early diagnostics and treatment for osteoporosis.

Purpose

To evaluate healthcare resource utilization (HCRU) and costs of care over 5 years after the incident osteoporotic fractures (OF) in postmenopausal women.

Methods

We used data from the National Health Insurance Service databases 2011–2018. Women aged ≥ 50 years with incident OF (OF group) were matched to women without OF (non-OF group). HCRU (inpatient, outpatient, and emergency room [ER] visits) and costs of care (inpatient, outpatient, and ER visits) during the 5-year follow-up period were derived after propensity score matching (PSM). Additionally, we identified women with subsequent fractures within the first 2 years after the incident OF.

Results

After PSM, 47,238 OF and 134,813 non-OF women were identified. HCRU rates and costs of care were highest in the first year after OF and decreased substantially, but remained higher in the OF group during the entire follow-up period. The increase in cumulative HCRU rates over 5 years was highest in inpatient admissions with ER visits (138% higher in OF vs non-OF). The cumulative total costs over 5 years were 73% higher in the OF group than in the non-OF group, which was mostly driven by inpatient costs. Trends were similar for women with subsequent fractures, but they generally showed higher HCRU and costs than those in the total OF group.

Conclusion

OF imposes a substantial and sustained economic burden on women, resulting in an approximately twofold increase in the cumulative cost over 5 years compared to women without fracture, which highlights the need for early diagnostics and treatment of osteoporosis.

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Data availability

Restrictions apply to the availability of the data. The original research data are not available due to the National Health Insurance Service’s strict confidentiality guidelines and regulations.

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Funding

This study was funded by Amgen Inc. and a grant (21153MFDS601) from Ministry of Food and Drug Safety in 2022.

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Authors and Affiliations

  1. Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA

    S. Han

  2. College of Pharmacy, Woosuk University, Wanju-gun, Jeollabuk-do, South Korea

    S. Kim

  3. Amgen Inc., Thousand Oaks, CA, USA

    E.J. Yeh

  4. College of Pharmacy, Kyung Hee University, Seoul, South Korea

    H.S. Suh

  5. Institute of Regulatory Innovation through Science (IRIS), Kyung Hee University, Seoul, South Korea

    H.S. Suh

  6. Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, South Korea

    H.S. Suh

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  1. S. Han
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  4. H.S. Suh
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Corresponding author

Correspondence to H.S. Suh.

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SH, SK, and HSS declare that they have no conflict of interest. EJY is an employee of Amgen Inc. and holds Amgen stock.

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Han, S., Kim, S., Yeh, E. et al. Understanding the long-term impact of incident osteoporotic fractures on healthcare utilization and costs in Korean postmenopausal women. Osteoporos Int 35, 339–352 (2024). https://doi.org/10.1007/s00198-023-06934-0

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  • DOI: https://doi.org/10.1007/s00198-023-06934-0

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