Economic Burden of Osteoporosis-Related Fractures in Medicaid

Abstract

The economic burden of osteoporosis-related fractures on state Medicaid budgets is substantial.

Estimating the excess costs for patients with incident fractures, prevalent fractures, and nonfracture osteoporosis

“…For example, in an unadjusted matching analysis, the prefracture costs were 16-17 % of the incident costs [8]. When both the cases and controls are required to have osteoporosis, effectively matching for a greater level of comorbidity, the cost in the pre-fracture period is 31 % of the post fracture period and 41 % in a concurrent control group [11]. When the matching includes employment status, the cost in the controls is 40 % of the incident fracture cases [10].…”

“…For example, some studies have estimated the excess cost of fractures in cases with fracture and osteoporosis to matched controls with osteoporosis without fracture [9][10][11]. A key difference in this method from a pre-post design is that the excess costs are focussed on the patient and not the clinical event which may reduce attribution bias [3,12].…”

Prevalence and costs of osteoporotic patients with subsequent non-vertebral fractures in the US

“…Consistent with existing NV fracture studies [7,8,10,19,23,28], specific NV fracture types included are femur, forearm (i.e., hand, radius, ulna, and wrist), hip, lower leg (i.e., ankle, fibula, foot, patella, and tibia), pelvis, ribs, upper arm (i.e., clavicle, humerus, and scapula), and multiple sites. In addition, the study provides insight into the characteristics of patients suffering from subsequent fractures through a descriptive assessment of comorbid conditions, health care resource use, and health care costs during the year following an incident fracture for subsequent fracture patients relative to those of NV fracture patients without subsequent fractures.…”

“…Additionally, although there is a substantial literature describing the rates of comorbidities and health care resource use as well as their associated costs for fracture patients as a whole [7][8][9][10][23][24][25][26], there is little detail on the characteristics, health outcomes, and economic burden of the subgroup of NV fracture patients who incur subsequent fractures. These patients are likely to be more severely ill and to place a greater cost burden on private and public insurers [27].…”

“…According to the National Osteoporosis Foundation, nearly 50% of women and 25% of men over age 50 will experience an osteoporosis-related fracture during their remaining lifetime [2]. Such fractures are associated with reduced quality of life and functional ability [3][4][5][6], higher costs [7][8][9][10], and higher mortality [11][12][13][14].…”