Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 2F.-220, No.33, Linsen S. Rd., Zhongzheng Dist, Taipei City, 100, Taiwan.
School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Arch Osteoporos. 2017 Oct 25;12(1):92. doi: 10.1007/s11657-017-0385-5.
This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan. The treatment of osteoporosis is alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to osteoporotic fractures.
This nationwide study investigated the epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture between 2009 and 2013 in Taiwan.
We used the National Health Insurance Research Database as our data source. The prevalence of diagnosed osteoporosis and major osteoporotic fractures was calculated annually from 2009 to 2013, stratified by age and gender. Osteoporosis patients who received any prescription of anti-osteoporosis drugs during each fiscal year were defined as osteoporosis patients under treatment. Healthcare utilization and associated direct medical costs were used to quantify the economic burden of osteoporosis. For patients who encountered major osteoporotic fracture, the incremental changes of direct medical costs attributable to fracture using a pre- and post-quasi-experimental design were estimated. Furthermore, we compared the annual direct medical costs of patients who encountered major osteoporotic fracture with those diagnosed osteoporosis only and with the general population.
The prevalence of diagnosed osteoporosis increased with age, with the highest rate among those aged 80 and older. Overall, less than one-third of women and only 10% of men received anti-osteoporosis drugs among osteoporosis patients. The annual direct medical costs for osteoporosis patients increased steadily from 2009 to 2013. The total medical costs and incremental change of direct medical costs were higher in men than those in women.
We found the treatment of osteoporosis to be alarmingly suboptimal, considering the significantly increased economic burden of major osteoporotic fracture also identified in this study. Osteoporosis men received lesser anti-osteoporosis drugs but had higher incremental costs attributable to major osteoporotic fractures.
本全国性研究调查了台湾地区骨质疏松症和相关骨折的流行病学、治疗模式和经济负担。考虑到主要骨质疏松性骨折带来的经济负担显著增加，骨质疏松症的治疗明显不理想。骨质疏松症男性接受的抗骨质疏松药物较少，但因骨质疏松性骨折而导致的增量成本较高。
本全国性研究调查了 2009 年至 2013 年期间台湾地区骨质疏松症和相关骨折的流行病学、治疗模式和经济负担。
我们使用国民健康保险研究数据库作为数据源。2009 年至 2013 年，按年龄和性别分层计算确诊骨质疏松症和主要骨质疏松性骨折的患病率。在每个财政年度接受任何抗骨质疏松药物处方的骨质疏松症患者被定义为接受治疗的骨质疏松症患者。利用医疗保健利用和相关直接医疗成本来量化骨质疏松症的经济负担。对于发生主要骨质疏松性骨折的患者，使用前后准实验设计估计骨折导致的直接医疗成本的增量变化。此外，我们比较了发生主要骨质疏松性骨折的患者、仅诊断为骨质疏松症的患者和一般人群的年度直接医疗成本。
确诊骨质疏松症的患病率随年龄增长而增加，80 岁及以上人群的患病率最高。总体而言，不到三分之一的女性和只有 10%的男性骨质疏松症患者接受抗骨质疏松药物治疗。2009 年至 2013 年，骨质疏松症患者的年度直接医疗成本稳步增加。男性的总医疗费用和直接医疗费用增量变化均高于女性。
考虑到本研究还确定了主要骨质疏松性骨折带来的经济负担显著增加，我们发现骨质疏松症的治疗明显不理想。骨质疏松症男性接受的抗骨质疏松药物较少，但因主要骨质疏松性骨折而导致的增量成本较高。
