Summary
Worldwide osteoporosis is underestimated and despite availability of effective and cost effective treatments, these are often not implemented. Apart from a demographically driven increase in disease cases, failure to implement or tardy implementation of preventive measures as well as poor treatment compliance leads to a deterioration of the health economic outcomes. This in turn causes considerable costs to the health care system and to society, through ineffective intake of medication, diminished quality of life and inability to work as well as substantial costs of rehabilitation of patients. Health economic analyses and methods are increasingly used by decision makers to set priorities and evaluate alternative treatment measures about their cost-effectiveness. In order to be able to capture the costs of illness incurred by osteoporosis, different diseases specific models and methods have been developed, such as the reference model of the IOF, an osteoporosis-specific Markov model or internationally comparable intervention thresholds. Health economists estimate that osteoporosis-related costs will double by 2050 in both Europe and the individual countries. For Europe this means an increase from €40 billion in 2000 to almost €80 billion in 2050. In Austria, an aggregation of the different costs of osteoporosis is not possible, due to a lack of comparability and availability of data. The international ICUROS study and the Austrian Osteoporosis Report 2007 are the first steps towards counteracting this situation.
Zusammenfassung
Osteoporose wird weltweit unterdiagnostiziert und trotz wirksamer und kosten-effektiver Therapien werden diese oft nicht angewandt. Abgesehen von einem demographisch bedingten Anstieg an Osteoporosefällen führen fehlende bzw. zu spät einsetzende Präventionsmaßnahmen und eine geringe Therapie-Compliance zu einer Verschlechterung des gesundheitsökonomischen Outcomes. Dies wiederum verursacht erhebliche Kosten im Gesundheitssystem und in der Gesellschaft, durch ineffektive Medikamenteneinnahme, Arbeitsunfähigkeit sowie erhebliche Kosten in der Rehabilitation der Patientinnen und Patienten. Dazu kommt die verminderte Lebensqualität der Betroffenen. Gesundheitsökonomische Bewertungen und Analysen werden immer häufiger von Entscheidungsträgern verwendet, um Prioritäten zu setzen und alternative Behandlungskonzepte auf ihre Kosten-Effektivität zu bewerten. Zur Bestimmung der Krankheits- und Folgekosten von Osteoporose wurden eigene Modelle entwickelt. So gibt es das Referenzmodell der IOF, ein eigenes validiertes Markov-Modell und Ansätze zur Ermittlung international vergleichbarer Schwellenwerte. Gesundheitsökonomen schätzen, dass sich die Osteoporose-bedingten Kosten sowohl für Europa als auch für die einzelnen Länder bis 2050 verdoppeln werden. Für Europa bedeutet dies einen Anstieg von etwa €40 Milliarden im Jahr 2000 auf fast €80 Milliarden 2050. Für Österreich ist eine Aggregierung der einzelnen Kostenblöcke derzeit nur schwer möglich, da sich Erhebungsmethoden und verwendetes Datenmaterial oft erheblich voneinander unterscheiden. Die ICUROS-Studie sowie der Österreichische Osteoporosebericht 2007 bieten erste Unterlagen, dieser Situation entgegen zu wirken.
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Viktoria Stein, K., Dorner, T., Lawrence, K. et al. Ökonomische Konzepte zur Erfassung der Krankheitskosten von Osteoporose: Österreich im internationalen Vergleich. Wien Med Wochenschr 159, 253–261 (2009). https://doi.org/10.1007/s10354-009-0674-8
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DOI: https://doi.org/10.1007/s10354-009-0674-8