Dunnewind Tom, Dvortsin Evgeni P, Smeets Hugo M, Konijn Rob M, Bos Jens H J, de Boer Pieter T, van den Bergh Joop P, Postma Maarten J
Unit of PharmacoTherapy, -Epidemiology and -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Unit of PharmacoTherapy, -Epidemiology and -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Asc Academics B.V., Groningen, The Netherlands.
Value Health. 2017 Jun;20(6):762-768. doi: 10.1016/j.jval.2017.02.006. Epub 2017 Mar 27.
Osteoporosis often does not involve symptoms, and so the actual number of patients with osteoporosis is higher than the number of diagnosed individuals. This underdiagnosis results in a treatment gap.
To estimate the total health care resource use and costs related to osteoporosis in the Netherlands, explicitly including fractures, and to estimate the proportion of fracture costs that are linked to the treatment gap and might therefore be potentially preventable; to also formulate, on the basis of these findings, strategies to optimize osteoporosis care and treatment and reduce its related costs.
In this retrospective study, data of the Achmea Health Database representing 4.2 million Dutch inhabitants were used to investigate the economic consequence of osteoporosis in the Netherlands in 2010. Specific cohorts were created to identify osteoporosis-related fractures and their costs. Besides, costs of pharmaceutical treatment regarding osteoporosis were included. Using data from the literature, the treatment gap was estimated. Sensitivity analysis was performed on the base-case results.
A total of 108,013 individuals with a history of fractures were included in this study. In this population, 59,193 patients were using anti-osteoporotic medication and 86,776 patients were using preventive supplements. A total number of 3,039 osteoporosis-related fractures occurred. The estimated total costs were €465 million. On the basis of data presented in the literature, the treatment gap in our study population was estimated to vary from 60% to 72%.
The estimated total costs corrected for treatment gap were €1.15 to €1.64 billion. These results indicate room for improvement in the health care policy against osteoporosis.
骨质疏松症通常没有症状,因此骨质疏松症患者的实际人数高于已确诊人数。这种诊断不足导致了治疗缺口。
估计荷兰与骨质疏松症相关的医疗保健资源总使用量和成本,明确包括骨折,并估计与治疗缺口相关且因此可能可预防的骨折成本比例;还根据这些研究结果制定优化骨质疏松症护理和治疗并降低其相关成本的策略。
在这项回顾性研究中,使用代表420万荷兰居民的阿赫玛健康数据库的数据来调查2010年荷兰骨质疏松症的经济后果。创建了特定队列以识别与骨质疏松症相关的骨折及其成本。此外,还纳入了骨质疏松症药物治疗的成本。利用文献数据估计治疗缺口。对基础病例结果进行敏感性分析。
本研究共纳入108,013名有骨折病史的个体。在该人群中,59,193名患者正在使用抗骨质疏松药物,86,776名患者正在使用预防性补充剂。共发生3,039例与骨质疏松症相关的骨折。估计总成本为4.65亿欧元。根据文献中的数据,我们研究人群中的治疗缺口估计在60%至72%之间。
校正治疗缺口后的估计总成本为€11.5亿至€16.4亿。这些结果表明在针对骨质疏松症的医疗保健政策方面有改进空间。