Burden of postmenopausal osteoporosis in Germany: estimations from a disease model
- 308 Downloads
This article describes the adaptation of a model assessing the incidence of osteoporotic fractures and prevalence of postmenopausal osteoporosis (PMO) in Germany.
The purpose of this paper is to estimate the epidemiological burden of PMO in Germany from 2010 to 2020.
For each year of the study, the ‘incident cohort’ (women experiencing a first osteoporotic fracture) was identified and run through a Markov model using 1-year cycles until 2020. Health states were based on the number of fractures (1, 2 or ≥3) and deaths. Although the fracture site was not explicitly accounted for in the model structure, the site (hip, vertebral, non-hip non-vertebral) was tracked for each health state. Transition probabilities reflected the site-specific risk of death and of subsequent fractures. Model inputs included population size and life tables from 1970 to 2020, incidence of fracture and BMD by age in the general population (mean and standard deviation).
In 2010, the number of osteoporotic fractures was estimated at 349,560 in women aged 50 years or more, including 80,177 hip and 48,550 vertebral fractures. By 2020, the population is expected to grow by 13.1 %. As a result, the number of fractures is predicted to increase by 15.2 %. The improvement in life expectancy is predicted to lead to a relatively smaller increase in the number of deaths attributable to fractures (+12.8 %), but also to an increase in the prevalence of women with multiple prior fractures (+25.5 %).
The PMO disease model, first developed for Sweden, was adapted to Germany. Due to the ageing of the population, the number of osteoporotic fractures is expected to increase markedly by +15.2 % by 2020.
KeywordsBone mineral density Epidemiology Fracture Osteoporosis T score Germany
- 2.Kanis JA, 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, Sheffield, Printed by the University of SheffieldGoogle Scholar
- 3.Department of Health and Human Services (2004) Bone health and osteoporosis. A report of the Surgeon General. Department of Health and Human Services, WashingtonGoogle Scholar
- 6.European Commission (1998) Report on osteoporosis in the European community. Action for prevention. http://www.iofbonehealth.org/download/osteofound/filemanager/publications/pdf/eu-report-1998.pdf. Accessed 29 Dec 2010
- 18.Kanis JA, Stevenson M, McCloskey EV, Davis S, Lloyd-Jones M (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 1(7):1–231, iii–iv, ix–xiGoogle Scholar
- 22.Human Mortality Database. http://www.mortality.org. Accessed on 31 July 2009
- 23.Eurostat. http://ec.europa.eu/Eurostat. Accessed 31 July 2009
- 24.Destatis. http://www.destatis.de. Accessed on 1 Aug 2009
- 25.De Lusignan S, Valentin T, Chan T, Hague N, Wood O, van Vlymen J, Dhoul N (2004) Problems with primary care data quality: osteoporosis as an exemplar. Inf Prim Care 12:147–156Google Scholar
- 26.National Institute for Clinical Excellence (NICE) (2010) Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women (amended). London. http://www.nice.org.uk/nicemedia/live/11746/47176/47176.pdf. Accessed 16 Nov 2010
- 32.Gesundheitsberichterstattung des Bundes. Krankenhausdiagnosestatistik. http://www.gbe-bund.de/glossar/Krankenhausdiagnosestatistik.html. Accessed 30 Dec 2010
- 34.U.S. Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, RockvilleGoogle Scholar