School of Population Health, The University of Queensland, Herston, Queensland, Australia.
Drugs Aging. 2010 Mar 1;27(3):255-64. doi: 10.2165/11318400-000000000-00000.
Osteoporosis is a common cause of disability and death in elderly men and women. Until 2007, Australian Government-subsidized use of oral bisphosphonates, raloxifene and calcitriol (1alpha,25-dihydroxycholecalciferol) was limited to secondary prevention (requiring x-ray evidence of previous low-trauma fracture). The cost to the Pharmaceutical Benefits Scheme was substantial (164 million Australian dollars in 2005/6).
To examine the dispensed prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products for the secondary prevention of osteoporosis (after previous low-trauma fracture) in the Australian population.
We analysed government data on prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products from 1995 to 2006, and by sex and age from 2002 to 2006. Prescription counts were converted to defined daily doses (DDD)/1000 population/day. This standardized drug utilization method used census population data, and adjusts for the effects of aging in the Australian population.
Total bisphosphonate use increased 460% from 2.19 to 12.26 DDD/1000 population/day between June 2000 and June 2006. The proportion of total bisphosphonate use in June 2006 was 75.1% alendronate, 24.6% risedronate and 0.3% etidronate. Raloxifene use in June 2006 was 1.32 DDD/1000 population/day. The weekly forms of alendronate and risedronate, introduced in 2001 and 2003, respectively, were quickly adopted. Bisphosphonate use peaked at age 80-89 years in females and 85-94 years in males, with 3-fold higher use in females than in males.
Pharmaceutical intervention for osteoporosis in Australia is increasing with most use in the elderly, the population at greatest risk of fracture. However, fracture prevalence in this population is considerably higher than prescribing of effective anti-osteoporosis medications, representing a missed opportunity for the quality use of medicines.
骨质疏松症是老年男女残疾和死亡的常见原因。直到 2007 年，澳大利亚政府补贴的口服双膦酸盐、雷洛昔芬和骨化三醇（1α，25-二羟胆钙化醇）的使用仅限于二级预防（需要 X 光证明有先前的低创伤性骨折）。该药物方案的成本很高（2005/6 年为 1.64 亿澳元）。
检查澳大利亚人群中用于骨质疏松症二级预防（既往低创伤性骨折后）的口服双膦酸盐、雷洛昔芬、骨化三醇和两种钙产品的处方。
我们分析了 1995 年至 2006 年政府关于口服双膦酸盐、雷洛昔芬、骨化三醇和两种钙产品的处方数据，并按性别和年龄分析了 2002 年至 2006 年的数据。将处方计数转换为特定日剂量（DDD）/1000 人/天。这种标准化药物利用方法使用人口普查数据，并调整了澳大利亚人口老龄化的影响。
2000 年 6 月至 2006 年 6 月期间，总双膦酸盐使用量增加了 460%，从 2.19 增至 12.26 DDD/1000 人/天。2006 年 6 月总双膦酸盐使用比例为：阿仑膦酸钠 75.1%、利塞膦酸钠 24.6%和依替膦酸二钠 0.3%。2006 年 6 月雷洛昔芬的使用量为 1.32 DDD/1000 人/天。分别于 2001 年和 2003 年推出的阿仑膦酸钠和利塞膦酸钠的每周制剂很快被采用。双膦酸盐的使用高峰出现在女性 80-89 岁和男性 85-94 岁，女性的使用量是男性的 3 倍。
澳大利亚骨质疏松症的药物干预正在增加，大多数患者为老年人，是骨折风险最高的人群。然而，该人群的骨折患病率明显高于有效抗骨质疏松药物的处方，这代表了合理用药的机会错失。
