This article is more than 5 years old. Information may no longer be current.
Cost for osteoporosis care rose 118% over 15 years in US
Click Here to Manage Email Alerts
Approximately 11% of middle-aged adults in the United States have osteoporosis, with the cost for care rising by nearly $50 billion over more than a decade, according to study data presented at the American Society for Bone and Mineral Research annual meeting.
“Osteoporosis remains a highly prevalent condition; however, based on data in the literature, osteoporosis is no longer just a condition observed among older, non-Hispanic white women,” Nicole Wright, PhD, MPH, assistant professor in the department of epidemiology at the University of Alabama at Birmingham, told Endocrine Today. “Osteoporosis is highly prevalent among Asian and Hispanic Americans, populations that may have limited knowledge about the disease and limited access to health care.”
Wright and colleagues analyzed prevalence estimates based on bone mineral density, using the 2010-2014 National Inpatient Sample (NIS) and the National Emergency Department Sample to determine prevalence of major fragility fractures at the hip, spine, pelvis, femur, wrist and humerus, and to assess temporal trends in fragility fractures. Researchers used NIS data to evaluate health care utilization, and Medical Expenditures Panel Survey data to estimate the economic burden of osteoporosis care.
Overall prevalence of osteoporosis, based on femoral neck and lumbar spine BMD, among adults aged at least 50 years was 11%, with a higher prevalence observed among women than men (16.5% vs. 5.1%).
In analyses stratified by race, the highest osteoporosis prevalence was observed among Asians (40% for women vs. 7.5% for men), followed by Hispanic adults, white adults and black adults. Prevalence also varied according to Hispanic origin; researchers found that Puerto Rican men were more likely to develop osteoporosis than men of other ethnicities (8.6% vs. 2.3% for Hispanic men and 3.9% for white men).
In assessing NIS data, researchers estimated that 2.8% of the 19.5 million discharges and 0.9% of the 46.7 million ED visits were for fragility fractures. Fracture prevalence differed by sex, age, and race; women, individuals aged at least 80 years and white adults had the highest osteoporosis prevalence at all fracture sites.
Between 2010 and 2014, the researchers noted a decrease in all fracture sites, ranging from 12% to 22%; however, they saw a 3.5% and 1.4% increase, respectively, in the number of hip and femur fracture discharges.
“The mean length of stay for all fragility fractures was 5.3 days, with the longest length of stay for femur (6.1 days) and the shortest for wrist fractures (3.6 days),” the researchers wrote. “Men, younger individuals and non-Hispanic blacks had longer length of stay than their comparator groups.”
Additionally, the researchers observed a 118% increase in total aggregate direct costs for adults with osteoporosis, rising from $28.1 billion in 1998-2000 to $73.6 billion in 2012-2014, with a “fairly equal distribution” between ambulatory care, inpatient and prescription costs.
“I know patient encounter time is limited, especially when patients are dealing with multiple comorbidities, but I would tell endocrinologists that if they have a postmenopausal patient or a man with significant risk factors for fracture, to talk to patients about their bone health, order a DXA scan if necessary,” Wright said. “Take the time to present the results and discuss treatment options when appropriate. Better communication between patients and health care providers can hopefully correct the current crisis in osteoporosis and fracture management.” – by Regina Schaffer
Reference:
Wright N, et al. Abstract 1079. Presented at: American Society of Bone and Mineral Research Annual Meeting; Sept. 20-23, 2019; Orlando.
Disclosure: Wright reports she has received grant and research support from Amgen.
Perspective
Back to Top
Rachel Pessah-Pollack, MD, FACD
This abstract presented at ASBMR provides important information regarding the prevalence of osteoporosis and major fragility fractures in the U.S. The authors found approximately 11% of adults aged at least 50 years in the U.S. have osteoporosis, with a gender distribution of 16.5% women and 5.1% men.
Notably, the authors defined subpopulations at risk, and the highest risk ethnicities are Asians (40% women, 7.5% men) followed by Hispanics. Puerto Rican men were more likely to develop osteoporosis than other men. Given the high prevalence of osteoporosis, particularly in certain ethnicities, this is a public health issue and an opportunity to identify, screen and treat at-risk groups, as they may not be receiving appropriate screening.
Another relevant finding of this study is the cost of osteoporosis care has dramatically increased 118% during the past 15 years in the U.S. To address this, fracture prevention through bone density screening, bone treatment when indicated and fall prevention are essential.
Patients that have already had a fracture are at high risk for a second fracture. A recent report by the National Osteoporosis Foundation found only 9% of women with Medicare fee-for-service had a bone density test within 6 months after a fracture. Identifying patients hospitalized for fractures and coordinating their discharge to ensure an osteoporosis work-up is performed (including bone density scans) and treatment offered is key. By preventing fractures, we can prevent hospitalizations (mean length of stay was 5.3 days for all fragility fractures), significantly reduce the costs of osteoporosis care and, most importantly, improve the quality of life of our patients.
Read more about
Click Here to Manage Email Alerts