Study Suggests Improved Adherence to Osteoporosis Drugs May Cut Healthcare Costs

Osteoporosis requires continual spending on drug therapy and examinations, however, what is known about the economic effects of the disease and osteoporotic fractures are limited. The results of a recent population-based study from Korea identified fractures, age, and medication adherence as factors that affect osteoporosis-related healthcare costs, and said improved medication adherence could save approximately $5 million of osteoporosis-related healthcare costs annually.

The Korea National Health Insurance Claims Database (KNHICD) was used to identify osteoporosis patients of at least 50 years old from 2011 to 2012. The study analyzed annual healthcare costs of osteoporosis from the insurer’s perspective and compared the costs between patients with fractures and those without. Also, medication adherence was defined throughout the study as patients with a medication possession ratio of at least 80%.

“Osteoporosis is the main risk factor for fractures. Fractures reduce quality of life by decreasing mobility and limiting daily and social activities,” explained the authors. “Moreover, fractures have been reported to greatly increase excess mortality. The mortality rate due to osteoporotic fractures within a year has been reported to be 21.0% for males and 15.0% for females.”

There was a total of 438,845 osteoporosis patients included in the study and 22% of the study population were adherent patients. Following a comparison among adherent and non-adherent patients, the researchers found that the major predictors of osteoporosis-related healthcare costs were age, medication adherence, and the occurrence of fractures.

Furthermore, the proportion of fractures among non-adherents was approximately 1.1 times the proportion of adherents. As for healthcare costs, patients with fractures faced 3.8 times the costs per patient without fractures. Patients with fractures also had higher healthcare costs due to hospitalization and outpatient costs, but had lower pharmacy costs than the non-adherents. If all of the non-adherents would become adherents, the researchers estimated that approximately $5 million of health insurance expenses could be saved annually.

“However, better adherence may increase medical care costs due to treatment and prevention costs associated with osteoporosis medication but the occurrence of fractures can lead to greater health care costs,” the authors stated. “As a result, improved adherence can save osteoporosis-related health care costs.”

The study recommended that persistent pharmacotherapy be used to prevent osteoporotic fractures and reduce healthcare costs for patients in the future.

“Our findings highlight the need for self-care of patients, engagement of pharmacists, and education on the importance of improving medication adherence for the prevention of fractures to reduce overall health care burden,” concluded the authors.

Reference

Cho H, Byun J, Song I, et al. Effect of improved medication adherence on health care costs in osteoporosis patients. Medicine (Baltimore). 2018;97(30) p e11470. doi: 10.1097/MD.0000000000011470