Scortichini Matteo, Dilecce Myriam, Spelta Massimo, Sammak Susan, Riegler Salvatore, Bartolini Fausto, Sciattella Paolo
Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome "Tor Vergata", Rome, Italy.
Amgen Italy, Milan, Italy.
Drugs Aging. 2025 Jul;42(7):643-653. doi: 10.1007/s40266-025-01211-7. Epub 2025 Jun 2.
Osteoporosis (OP) represents a public health challenge, with OP fractures associated with high morbidity, mortality, and economic burden, and fracture risk increasing with age. We evaluated the treatment gap, subsequent fracture rate, and medical costs among patients with OP hip fracture in Italy.
From two regional administrative databases, our retrospective cohort study included adults aged ≥ 50 years hospitalized for a first OP hip fracture (index fracture; 1 January 2015 to 31 December 2018).
percentage of patients not prescribed OP treatment in the 6 months following index fracture; fracture and mortality rates (mortality data only available for one region), direct medical costs, persistence and adherence to OP treatment in the 12 months following index fracture (follow-up).
Of 23,961 eligible patients, 87.8% (n = 21,028) were not prescribed OP treatment in the 6 months post-index fracture, with low 12-month persistence (33.7%) and adherence (9.6%) among treated patients. During follow-up, fracture and mortality rates were 36.9 and 280.9 per 1000 patient-years, respectively; higher in non-treated versus treated (39.3 versus 24.0 and 303.7 versus 126.7) patients. Mean (SD) cost per patient was €4963 (€5509); higher in non-persistent versus persistent patients (€5832 versus €4817).
Among patients from two Italian regions experiencing a first hip fracture, we observed a large treatment gap, and high subsequent fracture rates and medical costs. Considering fracture risk increases with age and a globally aging population, these costs are likely to increase and pose a substantial burden on the Italian health service.
骨质疏松症（OP）是一项公共卫生挑战，OP骨折与高发病率、死亡率及经济负担相关，且骨折风险随年龄增长而增加。我们评估了意大利OP髋部骨折患者的治疗缺口、后续骨折率及医疗费用。
我们的回顾性队列研究从两个地区行政数据库纳入了年龄≥50岁因首次OP髋部骨折住院（索引骨折；2015年1月1日至2018年12月31日）的成年人。
索引骨折后6个月未接受OP治疗的患者百分比；骨折率和死亡率（仅一个地区有死亡率数据）、直接医疗费用、索引骨折后12个月（随访）内OP治疗的持续性和依从性。
在23961名符合条件的患者中，87.8%（n = 21028）在索引骨折后6个月未接受OP治疗，接受治疗的患者12个月持续性（33.7%）和依从性（9.6%）较低。随访期间，骨折率和死亡率分别为每1000患者年36.9和280.9；未治疗患者高于治疗患者（39.3对24.0以及303.7对126.7）。每位患者的平均（标准差）费用为4963欧元（5509欧元）；非持续性患者高于持续性患者（5832欧元对4817欧元）。
在意大利两个地区首次发生髋部骨折的患者中，我们观察到较大的治疗缺口、较高的后续骨折率和医疗费用。考虑到骨折风险随年龄增长而增加以及全球人口老龄化，这些费用可能会增加，并给意大利医疗服务带来沉重负担。
