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Comparison of direct health care costs related to the pharmacological treatment of osteoporosis and to the management of osteoporotic fractures among compliant and noncompliant users of alendronate and risedronate: a population-based study

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Abstract

Summary

This population-based study aimed to compare direct health care costs related to the pharmacological treatment of osteoporosis and to the management of osteoporotic fractures among compliant and noncompliant users of alendronate and risedronate. During a 2-year follow-up period, compared to those with medication possession ratio (MPR) ≥ 80%, women with MPR < 80% incurred significantly higher physician care costs and hospital care costs.

Introduction

This study aimed to compare direct health care costs related to the treatment of osteoporosis and osteoporotic fractures among compliant and noncompliant users of alendronate and risedronate.

Methods

A cohort of 15,027 women having initiated alendronate or risedronate was identified. MPR and direct health care costs (physician care, hospital care, drugs) were assessed during a 2-year period. Regression models were used to estimate mean predicted cost for compliant (MPR ≥ 80%) and noncompliant (MPR < 80%) women.

Results

Mean predicted physician care cost (in Canadian dollars) was $51 among women with MPR < 80% and $34 among those with MPR ≥ 80%: mean difference $17, 95% confidence interval (CI) $2–22. Mean predicted hospital care cost was $568 among women with MPR < 80% and $379 among those with MPR ≥ 80%: mean difference $189, 95% CI $56–320. Mean predicted drug cost was $439 among women with MPR < 80% and $1,068 among those with MPR ≥ 80%: mean difference $−639, 95% CI $−649 to −629.

Conclusion

Compared to compliant women, noncompliant women incurred significantly higher physician care and hospital care costs. Due to lower drug costs, total direct health care costs were lower among noncompliant women.

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Acknowledgment

This study was funded by a grant from the Canadian Institutes of Health Research (Ottawa, Ontario, Canada). Julie Blouin is the recipient of a graduate scholarship in pharmaceutical sciences offered jointly by the Rx&D Health Research Foundation and the Faculty of Pharmacy of the University of Montreal. Dr. Sylvie Perreault is a research scholars receiving financial support from the Fonds de la recherche en santé du Québec.

Conflicts of interest

LGSM has received research grants and honoraria for lectures and/or is a board member of Alliance for better bone health—Proctor & Gamble Pharmaceuticals and Sanofi Aventis Canada Inc, Eli Lilly Inc, Hoffmann-Laroche Limited, Merck Frosst, and Novartis Pharma Inc. Other authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Faculty of Pharmacy, University of Montreal, PO Box 6128, Centre-Ville Station, Montreal, Quebec, Canada, H3C 3J7

    J. Blouin, A. Dragomir & S. Perreault

  2. Department of Management Sciences, HEC Montreal, Montreal, Canada

    M. Fredette

  3. Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada

    L.-G. Ste-Marie & J. C. Fernandes

Authors
  1. J. Blouin
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  2. A. Dragomir
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  3. M. Fredette
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  4. L.-G. Ste-Marie
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  5. J. C. Fernandes
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  6. S. Perreault
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Corresponding author

Correspondence to S. Perreault.

Additional information

 

This study was funded by a grant from the Canadian Institutes of Health Research (Ottawa, Canada)

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Blouin, J., Dragomir, A., Fredette, M. et al. Comparison of direct health care costs related to the pharmacological treatment of osteoporosis and to the management of osteoporotic fractures among compliant and noncompliant users of alendronate and risedronate: a population-based study. Osteoporos Int 20, 1571–1581 (2009). https://doi.org/10.1007/s00198-008-0818-5

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  • DOI: https://doi.org/10.1007/s00198-008-0818-5

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