Center for Health Economics and Science Policy, United BioSource Corporation, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, USA.
Osteoporos Int. 2011 Jun;22(6):1835-44. doi: 10.1007/s00198-010-1419-7. Epub 2010 Dec 17.
Prior national cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. Based on a random population-based sample of older adults, the US medical cost of osteoporosis and fractures is estimated at $22 billion in 2008.
National cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. We sought to characterize prevalence and costs for osteoporosis using a random population-based sample of older adults.
A cross-sectional estimate of medical cost was made with 2002 data from the Medicare Current Beneficiary Survey (MCBS). MCBS combines health interviews with claims information from all payers to profile a random sample of 12,700 Medicare recipients. Three cohorts aged 65 or over were defined: (1) patients experiencing a fracture-related claim in 2002; (2) patients with a diagnosis, medication, or self-report for osteoporosis or past hip fracture; and (3) non-case controls. The total cost of patient claims was compared to that of controls using multiple regression.
Of 30.2 million elderly Medicare recipients in 2002, 1.6 million (5%) were treated for a fracture that year, and an additional 7.2 million (24%) have osteoporosis without a fracture. The estimated mean impact of fractures on annual medical cost was $8,600 (95% confidence interval, $6,400 to $10,800), implying a US cost of $14 billion ($10 to $17 billion). Half of the non-fracture osteoporosis patients received drug treatment, averaging $500 per treated patient, or $2 billion nationwide.
The annual cost of osteoporosis and fractures in the US elderly was estimated at $16 billion, using a national 2002 population-based sample. This amount corroborates previous estimates based on substantially different methodologies. Projected to 2008, the national cost of osteoporosis and fractures was $22 billion.
先前美国骨质疏松症和骨折的国家成本估算基于各种提供者数据或选定的商业保险索赔。基于对老年人群体的随机人群抽样，2008 年美国骨质疏松症和骨折的医疗费用估计为 220 亿美元。
先前美国骨质疏松症和骨折的国家成本估算基于各种提供者数据或选定的商业保险索赔。我们试图使用老年人群体的随机人群抽样来描述骨质疏松症的患病率和成本。
2002 年来自医疗保险当前受益人调查（MCBS）的数据进行了医疗费用的横断面估算。MCBS 将健康访谈与所有付款人的索赔信息相结合，对 12700 名医疗保险受助人的随机样本进行了分析。定义了三个年龄在 65 岁或以上的队列：（1）2002 年发生骨折相关索赔的患者；（2）患有骨质疏松症或过去髋部骨折诊断、药物治疗或自我报告的患者；（3）非病例对照者。使用多元回归比较患者索赔的总成本与对照者的总成本。
在 2002 年的 3020 万老年医疗保险受助人中，有 160 万人（5%）当年接受了骨折治疗，另有 720 万人（24%）患有骨质疏松症但无骨折。骨折对年度医疗费用的估计平均影响为 8600 美元（95%置信区间，6400 美元至 10800 美元），意味着美国的成本为 140 亿美元（100 亿至 170 亿美元）。一半的非骨折骨质疏松症患者接受了药物治疗，每位治疗患者平均花费 500 美元，全国范围内为 20 亿美元。
使用 2002 年全国基于人群的样本，估计美国老年人群的骨质疏松症和骨折的年度费用为 160 亿美元。这一数额与以前基于完全不同方法的估计相符。预计到 2008 年，美国骨质疏松症和骨折的全国成本将为 220 亿美元。
