Use of antiosteoporotic drugs and calcium/vitamin D in patients with fragility fractures: impact on re-fracture and mortality risk

<p>Economic Burden of Osteoporotic Patients with Fracture: Effect of Treatment With or Without Calcium/Vitamin D Supplements</p>

“…Healthcare costs in osteoporotic patients with a fracture were lower in the treated group compared to untreated ones, and even lower in patients also receiving supplementation with calcium/vitamin D. These findings also parallel an improvement in the risk of re-fracture and mortality that we have described in a separate publication. 24 Briefly, over a 3-year period, the risk of subsequent fractures was 44.4% lower in treated patients compared to untreated ones (HR = 0.56, 95% CI = 0.42-0.74, p<0.001) and 64.4% lower in those receiving calcium/vitamin D supplementation compared to osteoporosis treatment only (HR = 0.36, 95% CI = 0.24-0.53, p<0.001). The risk of re-fracture was 77.2% lower in treated patients who were adherent to medication (HR=0.23, 95% CI = 0.14-0.38, p<0.001).…”

“…Treated patients had 64% lower mortality risk over the follow-up compared to untreated ones (HR = 0.36, 95% CI = 0.31-0.42, p<0.001). 24 To the best of our knowledge, only one prior study has investigated economic outcomes among osteoporotic patients, 27 showing that, compared to no treatment, supplementation with calcium/vitamin D was costeffective in a population of osteoporotic patients aged over 60 years. However, the objective of this study differs from ours: the study by Hiligsmann et al 27 was a cost-effectiveness evaluation of the supplementation with calcium and vitamin D in elderly women and men with osteoporosis, presented in terms of incremental cost-effectiveness ratio based on the cost per quality-adjusted life-years; here we aimed to assess healthcare cost, and the cost of each item, in a population of osteoporotic patients after a first fracture event, according to the presence of specific osteoporosis treatment and calcium/ vitamin D supply.…”

“…The study design, data extraction and information on patient characteristics have been previously described in detail. 24 Briefly, the following databases were assessed: Beneficiary DBs, Hospitalization DBs, Pharmaceuticals DBs and Payment Exemption DBs. All patients were identified in DBs using an anonymous code and data were extracted by the staff of the LHUs and their DBs were anonymized according to the Legislative Decree 196/03.…”

“…Patient characteristics have previously been described in detail. 24 Baseline and clinical characteristics of the study population and by type of treatment received are reported in Table 2.…”

“…23 Unfortunately, many osteoporosis patients do not receive specific treatment after a fracture, showing poor adherence to national guidelines, even if osteoporosis drug treatment (and to a greater extent in combination with calcium/vitamin D) is associated with a lower risk of both re-fracture and all-cause mortality. 24 The aim of this study was to assess healthcare costs in an Italian cohort of osteoporotic patients with a fracture, focusing on the presence of specific osteoporosis treatment and supplementation with calcium/vitamin D.…”