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

Pike, Crystal; Birnbaum, Howard G.; Schiller, M.; Swallow, Elyse; Burge, Russel; Edgell, E.T.

doi:10.1007/s00198-010-1494-9

Cited by 32 publications

(29 citation statements)

References 33 publications

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“…The treatment costs borne by the patients with the second fracture were significantly higher compared with single fracture patient, which is consistent with previous studies in USA and UK [ 16 – 18 ]. In this study, those with the second vertebral fracture bore more than twice of total medical costs and fracture treatment costs when comparing their point estimates with those with a single vertebral fracture.…”

Section: Discussionsupporting

confidence: 91%

Treatment costs and cost drivers among osteoporotic fracture patients in Japan: a retrospective database analysis

Taguchi

Inoue²,

Kido³

et al. 2018

Arch Osteoporos

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SummaryThis study estimated the direct medical costs of osteoporotic fractures from a large claim database in Japan. We further identified several comorbidities which drove the treatment costs. The results would contribute to health economic analysis as well as understanding of individual financial burden in Japan.IntroductionThe purposes of this study were to estimate treatment costs of osteoporotic fractures and to investigate the cost drivers.MethodsMale and female patients aged 50 years and older with a hip, vertebral, or non-hip/non-vert (NHNV) fracture between April 2008 and December 2016 were analyzed from claim database. Two types of costs were estimated. The incremental yearly costs of fractures and comorbidity treatments (total medical costs) were calculated by subtracting pre-fracture costs from post-fracture costs. The costs exclusive for fracture treatments (fracture treatment costs) were estimated by summing up the costs of fracture treatments within 1 year after fracture. The associations between comorbidities and costs were examined with a generalized linear model.ResultsTotal 12,898 patients were identified (83% was female). The total medical costs of fractures were $14,592 for male-hip, $15,691 for female-hip, $4268 for male-vertebral, $3819 for female-vertebral, $3790 for male-NHNV, and $4259 for female-NHNV. The fracture treatment costs were $4506 for male-hip, $5427 for female-hip, $1022 for male-vertebral, $1044 for female-vertebral, $1035 for male-NHNV, and $1408 for female NHNV. Three comorbidities were associated with increasing fracture treatment costs whereas four comorbidities were associated with decreasing fracture treatment costs. Five comorbidities were associated with increasing total medical costs whereas one comorbidity was associated with decreasing total medical costs.ConclusionsYearly treatment costs were increased considerably after fracture. Several comorbidities were considered to be cost drivers for osteoporotic fracture treatment. The cost estimates with different patient profile would support conducting health economic analysis in the future.

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Section: Discussionsupporting

confidence: 91%

Treatment costs and cost drivers among osteoporotic fracture patients in Japan: a retrospective database analysis

Taguchi

Inoue²,

Kido³

et al. 2018

Arch Osteoporos

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“…In the base case analysis, we assumed the FLS is offered to all patients hospitalized with an index hip fracture. We assumed 75% of postfracture patients are female with an age distribution similar to that reported in several large studies of patients with an index fracture . We assumed 80% have low BMD—osteopenia or osteoporosis—based on data from a Canadian postfracture study…”

Section: Methodsmentioning

confidence: 99%

“…We assumed 75% of postfracture patients are female with an age distribution similar to that reported in several large studies of patients with an index fracture. (12)(13)(14) We assumed 80% have low BMDosteopenia or osteoporosis-based on data from a Canadian postfracture study. (15) The universal FLS strategy assumed that all patients receive care, whereas the targeted DXA strategy assumed FLS follow-up only for patients with low BMD.…”

Section: Characteristics Of Flsmentioning

confidence: 99%

The Potential Economic Benefits of Improved Postfracture Care: A Cost-Effectiveness Analysis of a Fracture Liaison Service in the US Health-Care System

Solomon

Patrick

Schousboe

et al. 2014

Journal of Bone and Mineral Research

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Fractures related to osteoporosis are associated with $20 billion in cost in the United States, with the majority of cost born by federal health-care programs, such as Medicare and Medicaid. Despite the proven fracture reduction benefits of several osteoporosis treatments, less than one-quarter of patients older than 65 years of age who fracture receive such care. A postfracture liaison service (FLS) has been developed in many health systems but has not been widely implemented in the United States. We developed a Markov state-transition computer simulation model to assess the cost-effectiveness of an FLS using a health-care system perspective. Using the model, we projected the lifetime costs and benefits of FLS, with or without a bone mineral density test, in men and women who had experienced a hip fracture. We estimated the costs and benefits of an FLS, the probabilities of refracture while on osteoporosis treatment, as well as the utilities associated with various health states from published literature. We used multi-way sensitivity analyses to examine impact of uncertainty in input parameters on cost-effectiveness of FLS. The model estimates that an FLS would result in 153 fewer fractures (109 hip, 5 wrist, 21 spine, 17 other), 37.43 more quality-adjusted life years (QALYs), and save $66,879 compared with typical postfracture care per every 10,000 postfracture patients. Doubling the cost of the FLS resulted in an incremental cost-effectiveness ratio (ICER) of $22,993 per QALY. The sensitivity analyses showed that results were robust to plausible ranges of input parameters; assuming the least favorable values of each of the major input parameters results in an ICER of $112,877 per QALY. An FLS targeting patients post-hip fracture should result in cost savings and reduced fractures under most scenarios.

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“…Some investigators 8 have indicated that subsequent fractures are associated with an even greater increase in mortality rates and a significant higher cost. Pike et al, 9 in a recent study, further recommended that nonvertebral fracture patients are at substantial risk for subsequent nonvertebral fractures within 1 year, and patients who incur subsequent fractures are significantly more costly than those who do not during the year following an incident fracture. However, most studies mainly focus on the rates of subsequent fractures and the incurred cost.…”

mentioning

confidence: 95%

Incidence of subsequent hip fractures is significantly increased within the first month after distal radius fracture in patients older than 60 years

Chen

Huang

et al. 2013

Journal of Trauma and Acute Care Surgery

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

Abstract: NV fracture patients are at substantial risk for subsequent NV fractures within 1 year, and patients who incur subsequent fractures are significantly more costly than those who do not during the year following an incident fracture.

Cited by 32 publications

References 33 publications

Treatment costs and cost drivers among osteoporotic fracture patients in Japan: a retrospective database analysis

Treatment costs and cost drivers among osteoporotic fracture patients in Japan: a retrospective database analysis

The Potential Economic Benefits of Improved Postfracture Care: A Cost-Effectiveness Analysis of a Fracture Liaison Service in the US Health-Care System

Incidence of subsequent hip fractures is significantly increased within the first month after distal radius fracture in patients older than 60 years

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