Chen-Yu Wang1,2, Shau-Huai Fu3, Rong-Sen Yang4, Li-Jiuan Shen1,2,5, Fe-Lin Lin Wu1,2,5, Fei-Yuan Hsiao6,7,8. 1. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 2F.-220, No.33, Linsen S. Rd., Zhongzheng Dist, Taipei City, 100, Taiwan. 2. School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. 3. Department of Orthopedics, National Taiwan University Hospital Yun-Lin Branch, Yunlin County, Taiwan. 4. Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan. 5. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. 6. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 2F.-220, No.33, Linsen S. Rd., Zhongzheng Dist, Taipei City, 100, Taiwan. fyshsiao@ntu.edu.tw. 7. School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. fyshsiao@ntu.edu.tw. 8. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. fyshsiao@ntu.edu.tw.
Abstract
This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan. The treatment of osteoporosis is alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to osteoporotic fractures. PURPOSE: This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture between 2009 and 2013 in Taiwan. METHODS: We used the National Health Insurance Research Database as our data source. The prevalence of diagnosed osteoporosis and major osteoporotic fractures was calculated annually from 2009 to 2013, stratified by age and gender. Osteoporosis patients who received any prescription of anti-osteoporosis drugs during each fiscal year were defined as osteoporosis patients under treatment. Healthcare utilization and associated direct medical costs were used to quantify the economic burden of osteoporosis. For patients who encountered major osteoporotic fracture, the incremental changes of direct medical costs attributable to fracture using a pre- and post-quasi-experimental design were estimated. Furthermore, we compared the annual direct medical costs of patients who encountered major osteoporotic fracture with those diagnosed osteoporosis only and with the general population. RESULTS: The prevalence of diagnosed osteoporosis increased with age, with the highest rate among those aged 80 and older. Overall, less than one-third of women and only 10% of men received anti-osteoporosis drugs among osteoporosis patients. The annual direct medical costs for osteoporosis patients increased steadily from 2009 to 2013. The total medical costs and incremental change of direct medical costs were higher in men than those in women. CONCLUSION: We found the treatment of osteoporosis to be alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture also identified in this study. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to major osteoporotic fractures.
This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan. The treatment of osteoporosis is alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture. Osteoporosismen received lesser anti-osteoporosis drugs but had higher incremental costs attributable to osteoporotic fractures. PURPOSE: This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture between 2009 and 2013 in Taiwan. METHODS: We used the National Health Insurance Research Database as our data source. The prevalence of diagnosed osteoporosis and major osteoporotic fractures was calculated annually from 2009 to 2013, stratified by age and gender. Osteoporosispatients who received any prescription of anti-osteoporosis drugs during each fiscal year were defined as osteoporosispatients under treatment. Healthcare utilization and associated direct medical costs were used to quantify the economic burden of osteoporosis. For patients who encountered major osteoporotic fracture, the incremental changes of direct medical costs attributable to fracture using a pre- and post-quasi-experimental design were estimated. Furthermore, we compared the annual direct medical costs of patients who encountered major osteoporotic fracture with those diagnosed osteoporosis only and with the general population. RESULTS: The prevalence of diagnosed osteoporosis increased with age, with the highest rate among those aged 80 and older. Overall, less than one-third of women and only 10% of men received anti-osteoporosis drugs among osteoporosispatients. The annual direct medical costs for osteoporosispatients increased steadily from 2009 to 2013. The total medical costs and incremental change of direct medical costs were higher in men than those in women. CONCLUSION: We found the treatment of osteoporosis to be alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture also identified in this study. Osteoporosismen received lesser anti-osteoporosis drugs but had higher incremental costs attributable to major osteoporotic fractures.