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A scorecard for osteoporosis in four Latin American countries: Brazil, Mexico, Colombia, and Argentina

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Abstract

Summary

The state of osteoporosis care in Latin America is not well known. The results of our scorecard indicate an urgent need to improve policy frameworks, service provision, and service uptake for osteoporosis in Brazil, Mexico, Colombia, and Argentina. The scorecard serves as an important marker to measure future progress.

Purpose

We developed a scorecard to summarize key indicators of the burden of osteoporosis and its management in Brazil, Mexico, Colombia, and Argentina. The goal of the scorecard is to reduce the risk of osteoporotic fractures by promoting healthcare policies that will improve patient access to timely diagnosis and treatment.

Methods

We conducted a systematic review of osteoporosis. We also interviewed several key opinion leaders to gather information on government policy, access to fracture risk assessments, and access to medications. We then leveraged a peer-reviewed template, initially applied to 27 European countries, to synthesize the information into a scorecard for Latin America. We presented information according to four main categories: burden of disease, policy framework, service provision, and service uptake and used a traffic light color coding system to indicate high, intermediate, and low risk.

Results

The systematic review included 108 references, of which 49 were specific to Brazil. The number of osteoporotic fractures in Brazil, Mexico, Colombia, and Argentina was forecasted to increase substantially (34% to 76% in each country) from 2015 to 2030. In general, policy frameworks, service provision, and service uptake were not structured to support current patients with osteoporosis and did not account for the future increases in fracture burden. Across all four countries, there was inadequate access to programs for secondary fracture prevention and only a small minority of patients received treatment for osteoporosis.

Conclusions

Osteoporosis management, including the rate of post-fracture care, is very poor in Brazil, Mexico, Colombia, and Argentina and needs to be strengthened. Improvements in the rates of care are necessary to curb the debilitating impact of osteoporotic fractures on patients and health systems.

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Acknowledgments

Frank O’Neill was instrumental in helping us to design the systematic review. We also thank the several physicians, payers, and HTA experts in Brazil, Mexico, Colombia, and Argentina who contributed invaluable information during the interviews. We are grateful for their insightful contributions.

Funding statement

This study was funded by Amgen Inc.

Author information

Authors and Affiliations

  1. Amgen Inc., 6775 Financial Dr #100, Mississauga, ON, L5N 0A4, Canada

    Rima Aziziyeh & Mo Amin

  2. Amgen Inc., Thousand Oaks, CA, USA

    Mohdhar Habib & Javier Garcia Perlaza

  3. Cornerstone Research Group Inc., Burlington, Ontario, Canada

    Rebecca K. McTavish, Ana Lüdke, Savannah Fernandes, Kaushik Sripada & Chris Cameron

Authors
  1. Rima Aziziyeh
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  2. Mo Amin
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Corresponding author

Correspondence to Rima Aziziyeh.

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Conflict of interest

Cornerstone received financial support from Amgen for the conduct of this study. RA, MH, and JGP are employees of Amgen. MA was an employee of Amgen at the time of writing the manuscript. RKM, SF, and KS are employees of Cornerstone, while AL is a subcontractor of Cornerstone. CC is an employee and shareholder of Cornerstone Research Group Inc. Cornerstone consults for various pharmaceutical, medical device, and biotech companies.

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Aziziyeh, R., Amin, M., Habib, M. et al. A scorecard for osteoporosis in four Latin American countries: Brazil, Mexico, Colombia, and Argentina. Arch Osteoporos 14, 69 (2019). https://doi.org/10.1007/s11657-019-0622-1

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