Direct healthcare costs of osteoporosis-related fractures in managed care patients receiving pharmacological osteoporosis therapy

Hema N. Viswanathan (), Jeffrey R. Curtis, Jingbo Yu, Jeffrey White, Bradley S. Stolshek, Claire Merinar, Akhila Balasubramanian, Joel D. Kallich, John L. Adams and Sally W. Wade
Additional contact information
Hema N. Viswanathan: Amgen Inc.
Jeffrey R. Curtis: University of Alabama at Birmingham
Jingbo Yu: HealthCore, Inc.
Jeffrey White: WellPoint Inc.
Bradley S. Stolshek: Amgen Inc.
Claire Merinar: Amgen Inc.
Akhila Balasubramanian: Amgen Inc.
Joel D. Kallich: Amgen Inc.
John L. Adams: RAND Corp.
Sally W. Wade: Wade Outcomes Research and Consulting

Applied Health Economics and Health Policy, 2012, vol. 10, issue 3, No 2, 163-173

Abstract: Abstract Background Osteoporosis is a common condition and the economic burden of osteoporosis-related fractures is significant. While studies have reported the incremental or attributable costs of osteoporosis-related fracture, data on the economic impact of osteoporosis-related fractures in commercial health plan populations are limited. Objective To estimate the direct costs of osteoporosis-related fractures among pharmacologically treated patients in a large, commercially insured population between 2005 and 2008. Methods In this retrospective cohort study, patients were identified from a large, commercially insured population with integrated pharmacy and medical claims. Inclusion criteria were age 45–64 years; one or more osteoporosis medication claim(s) with first (index) claim between 1 January 2005 and 30 April 2008; and continuous insurance coverage for ≥12 months pre-index and ≥6 months post-index. Patients with pre-index Paget’s disease or malignant neoplasm; skilled nursing facility stay; combination therapy at index; or fracture ≤6 months post-index were excluded. A generalized linear model compared differences in 6-month pre-/post-event costs for patients with and without fracture. Propensity score weighting was used to ensure comparability of fracture and non-fracture patients. Generalized estimating equations accounted for repeated measures. Results The study included 49 680 patients (2613 with fracture) with a mean (SD) age of 56.4 (4.7) years; 95.9% were female. Mean differences between pre- and post-event direct costs were $US14049 (95% CI 7670, 20 428) for patients with vertebral fractures, $US16 663 (95% CI 11690, 21636) for patients with hip fractures, and $US7582 (95% CI 6532, 8632) for patients with other fractures. After adjusting for covariates, osteoporosis-related fractures were associated with an additional $US9996 (95% CI 8838, 11154; p

Keywords: Vertebral Fracture; Osteoporosis Medication; Direct Healthcare Cost; Fracture Cohort; Vertebral Fracture Patient (search for similar items in EconPapers)
Date: 2012
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DOI: 10.2165/11598590-000000000-00000

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