Friday, 13 Sep 2019

You are here

Cost of Osteoporosis Care in the USA

The 2010 NHANES study suggests that the overall prevalence of osteoporosis (OP) in the USA is ~10% or 10.2 million older adults (> 50 yrs) had osteoporosis.  This combined with the ~44% prevalence of low bone mass (43.4 million) highlights the public health problem of OP and osteopenia in the USA.

An analysis by the NIH-NIAMS shows that $990 million dollars was spent on anti-osteoporosis drugs in 2013. 

This data is based on Medicare patients receiving anti-osteoporotic therapy in 2013. $756 million (77%) was attributable to brand name drugs. Generic dispensing rate varied from 57-86% across the different states in the USA. 

Despite this cost, only one in two adults with osteoporosis aged 65 and older received a prescription for an anti-osteoporosis drug.

Thirty-eight percent of the total prescriptions from orthopedic surgeons were for Forteo® or Prolia® compared to 12.5 % from specialists.

These findings highlight the need for ongoing training for physicians who engage in the care of patients with osteoporosis to manage the disease in a cost-effective manner.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement

JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.

Weight Loss Cuts Hospital Stays for Obese TKA Patients

Morbidly obese patients who lost 20 lbs before total knee arthroplasty (TKA) cut their hospital stays by about 1 day, and were 76% less likely to have an extended hospital stay, research showed. 

High-Dose Vitamin D: No Help for Bone Health

Vitamin D might not be much help for strengthening bones among healthy adults without osteoporosis, Canadian researchers reported, even at doses far higher than recommended daily allowances. In a clinical trial assessing three levels of daily vitamin D supplementation -- 400 IU, 4,000 IU, and 10,000 IU -- radial volumetric bone mineral density was significantly lower among those (ages 55-70) taking higher doses for 3 years, according to Steven Boyd, PhD, of the University of Calgary in Canada, and colleagues.

Osteoporosis Tx: Good for Bones, but Not for Cutting Death Risk

Osteoporosis treatments were not linked with reduced overall mortality, according to a meta-analysis of placebo-controlled trial data.

Looking at data from 38 clinical trials, there was no significant association found between all drug-based osteoporosis treatments and overall mortality rate (risk ratio 0.98, 95% CI 0.91-1.05), reported Steven Cummings, MD, of the San Francisco Coordinating Center, and colleagues.

Bisphosphonate Use Associated with Reduced Mortality

The Journal of Bone and Mineral Research (JBMR) has published a report showing that a reduction in the rate of bone loss by nitrogen bisphosphonates was associated with a 40% lower mortality risk.

Accelerated bone loss has been shown to be an independent predictor of mortality risk, but the relationship between bisphosphonates, bone loss, and mortality is unknown.