Ott Laius1,2, Heti Pisarev3, Katre Maasalu4,5, Sulev Kõks6, Aare Märtson4,5. 1. Department of Traumatology and Orthopedics, University of Tartu, L. Puusepa 8, Tartu, Estonia. ott.laius@ravimiamet.ee. 2. Estonian State Agency of Medicines, Nooruse 1, 50411, Tartu, Estonia. ott.laius@ravimiamet.ee. 3. Institute of Family Medicine and Public Health, Department of Epidemiology and Biostatistics, University of Tartu, Ravila, 19, Tartu, Estonia. 4. Department of Traumatology and Orthopedics, University of Tartu, L. Puusepa 8, Tartu, Estonia. 5. Clinic of Traumatology and Orthopaedics, Tartu University Hospital, L. Puusepa 8, Tartu, Estonia. 6. Institute of Biomedicine and Translational Medicine, Department of Pathophysiology, University of Tartu, Ravila, 19, Tartu, Estonia.
Abstract
Osteoporosis medicines reduce osteoporotic fractures. There is a very strong negative correlation between the consumption of medicines and the price of an average daily dose indicating that affordability is a key factor that could increase consumption of antiosteoporotic medicines and, through that, reduce fractures. PURPOSE: Osteoporosis is a major cause of morbidity and mortality in the modern world. Our study aims to describe the trends in incidence of hip fractures in relation to drug utilization patterns and the average price of antiosteoporotic medicines in Estonia. METHODS: Data on hip fractures was obtained from the medical claims database of Estonian Health Insurance Fund (EHIF). Consumption and price data was obtained from the Estonian State Agency of Medicines (SAM).Consumption is presented using WHO defined daily doses methodology, and the prices reflect the average wholesale price of medicines. RESULTS: From 2004 to 2010 there was a non-significant increasing trend in standardized hip fracture incidence in Estonia, but from 2010 to 2015, the trend turned to a significant decrease of 4.5% per year. The consumption of osteoporosis medication increased significantly from 2004 to 2009 by yearly average of 41.2%. After 2009, the consumption levelled. On contrast, the average price of one daily dose of osteoporosis medication decreased significantly from 2004 to 2009 by 16.9% per year and the decrease also levelled after 2009. This gives a very strong negative correlation of -0.93 (p < 0.001) between the consumption of antiosteoporotic medication and the average price of a daily dose of medication during the study period. CONCLUSIONS: The statistically significant decline of standardized incidence of hip fractures from 2010 onward could at least in part be the result of the high increase in consumption of antiosteoporotic medicines which in turn is strongly negatively correlated with the average price of osteoporosis medicines.
Osteoporosis medicines reduce osteoporotic fractures. There is a very strong negative correlation between the consumption of medicines and the price of an average daily dose indicating that affordability is a key factor that could increase consumption of antiosteoporotic medicines and, through that, reduce fractures. PURPOSE:Osteoporosis is a major cause of morbidity and mortality in the modern world. Our study aims to describe the trends in incidence of hip fractures in relation to drug utilization patterns and the average price of antiosteoporotic medicines in Estonia. METHODS: Data on hip fractures was obtained from the medical claims database of Estonian Health Insurance Fund (EHIF). Consumption and price data was obtained from the Estonian State Agency of Medicines (SAM).Consumption is presented using WHO defined daily doses methodology, and the prices reflect the average wholesale price of medicines. RESULTS: From 2004 to 2010 there was a non-significant increasing trend in standardized hip fracture incidence in Estonia, but from 2010 to 2015, the trend turned to a significant decrease of 4.5% per year. The consumption of osteoporosis medication increased significantly from 2004 to 2009 by yearly average of 41.2%. After 2009, the consumption levelled. On contrast, the average price of one daily dose of osteoporosis medication decreased significantly from 2004 to 2009 by 16.9% per year and the decrease also levelled after 2009. This gives a very strong negative correlation of -0.93 (p < 0.001) between the consumption of antiosteoporotic medication and the average price of a daily dose of medication during the study period. CONCLUSIONS: The statistically significant decline of standardized incidence of hip fractures from 2010 onward could at least in part be the result of the high increase in consumption of antiosteoporotic medicines which in turn is strongly negatively correlated with the average price of osteoporosis medicines.
Entities:
Keywords:
Adherence; Drug utilization; Estonia; Hip fracture; Incidence; Osteoporosis
Authors: Marta M Rey-Rodriguez; M A Vazquez-Gamez; Mercè Giner; Fernando Garrachón-Vallo; Luis Fernández-López; Miguel Angel Colmenero; María-José Montoya-García Journal: BMJ Open Date: 2020-09-24 Impact factor: 2.692