Abstract
To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX® or the current criteria were used to determine access to reimbursement. This is a retrospective study based on data from 1,000 women randomly selected from an outpatient hospital specialized in bone metabolism in Belgium. Proportions of potentially refunded treatments between FRAX® and current criteria were compared. Out of the 1,000 women files, 890 have sufficient information to assess FRAX®. In Belgium, current criteria include a bone mineral density (BMD) T score below −2.5 at the lumbar spine, the femoral neck or the total hip and/or at least a prevalent vertebral fracture. Using these criteria, 167 women (18.8 %) would have access to reimbursement. Using the criteria based on the validated Belgian FRAX® tool, only 116 women (13.0 %) would have access to reimbursement, meaning that access to reimbursement based on FRAX® criteria would reduce by 30 % the anti-osteoporosis drug expenses covered by the national social security. Interestingly, only 65 women out of the 116 (56.0 %) selected with the FRAX® criteria were also selected with the current criteria of the national social security. A substantial proportion of individuals that would potentially receive a reimbursement for their treatment using the FRAX® criteria do not have access to any refund for their treatment with the current criteria. Since patients identified with the FRAX® tool are those with the highest risk profile for future fractures, reappraisals of treatment reimbursement guidelines are expected in Belgium.
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Bruyère, O., Fossi, M., Zegels, B. et al. Comparison of the proportion of patients potentially treated with an anti-osteoporotic drug using the current criteria of the Belgian national social security and the new suggested FRAX® criteria. Rheumatol Int 33, 973–978 (2013). https://doi.org/10.1007/s00296-012-2460-y
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DOI: https://doi.org/10.1007/s00296-012-2460-y