Current and future economic burden of osteoporosis in New Zealand
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Osteoporosis is recognized as a serious health condition in developed as well as developing countries. There are no accurate estimates of the extent of the burden of osteoporosis in New Zealand. The purpose of this study was to estimate the economic burden of osteoporosis in New Zealand using data from international studies and population and health services information from New Zealand.
To estimate the number of osteoporotic fractures and cost of treatment and management of osteoporosis and osteoporotic fractures to the health system in New Zealand in 2007 and to project the future burden in 2013 and 2020.
Hospitalizations for hip fractures were combined with New Zealand census data and estimates from previous studies to estimate the expected number of osteoporotic vertebral, humeral, pelvic and other sites fractures in 2007. Health services usage and costs were estimated by combining data from New Zealand hospitals, the New Zealand Health Survey on the number of people diagnosed with osteoporosis, and the New Zealand Health Information Service (NZHIS) on pharmaceutical treatments. All prices are in New Zealand dollars ($NZ), year 2007 values. Losses in QALYs resulting from osteoporotic fractures were used to indicate the impact on morbidity and mortality. The lost QALYs and economic cost associated with osteoporosis were projected to 2013 and 2020 using population projections from the New Zealand census.
There were an estimated 84 354 osteoporotic fractures in New Zealand in 2007, including 3803 hip and 27994 vertebral fractures. Osteoporosis resulted in a loss of 11249 QALYs. The total direct cost of osteoporosis was $NZ330 million, including $NZ212 million to treat the fractures, $NZ85 million for care after fractures and $NZ34 million for treatment and management of the estimated 70 631 people diagnosed with osteoporosis. Sensitivity analysis suggested the results were robust to assumptions regarding the number of fractures receiving medical treatment. Hospitalization costs represented a significant component of total costs. The cost of treatment and management of osteoporosis is expected to increase to over $NZ391 million in 2013 and $NZ458 million in 2020, with the number of QALYs lost increasing to 13 205 in 2013 and 15 176 in 2020.
Osteoporosis and osteoporotic fractures create a significant burden on the health system in New Zealand. This study highlights the significant scope of the burden of osteoporosis and the potential gains that might be made from introducing interventions to mitigate the burden.
The paper is based on a report commissioned and funded by Osteoporosis New Zealand (http://www.bones.org.nz), a not-for-profit organization in New Zealand. The authors would like to acknowledge the expert clinical advice given by the Scientific Advisory Committee, especially Julia Gallagher, Professor Ian Reid, Dr Brandon Orr-Walker, Julie Harris and Gillian Robb. Paul Brown is now also employed by the School of Social Sciences, Humanities and Arts, University of California, Merced, CA, USA. The authors have no conflicts of interest that are directly relevant to the content of this article.
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