Primary Care Resource Utilization and Costs of Imminent Subsequent Fractures in Postmenopausal Women: A Distributed Network Analysis Using Data Mapped to OMOP Common Data Model From Five European Countries

Author(s)

Fabiano G1, Chen X1, Rashod-Mistry T1, Delmestri A1, Moayyeri A2, Warden J2, Reyes C3, Fernandez Bertolin S3, Brash JT4, Verhamme K5, Tan EH1, Pinedo-Villanueva R1
1University of Oxford, Oxford, OXF, UK, 2UCB Pharma, Slough, UK, 3Institut Universitari d'investigació en Atenció Primària "Jordi Gol", Barcelona, Spain, 4IQVIA, Brighton, UK, 5Erasmus MC, Rotterdam, Netherlands

OBJECTIVES: To describe primary care resource utilisation and costs of index and imminent subsequent fragility fractures in postmenopausal women using electronic medical records from the United Kingdom (CPRD-Aurum), the Netherlands (IPCI), Spain (SIDIAP), Germany (IQVIA-DA), and France (IQVIA-LPD) mapped to the OMOP-CDM.

METHODS: A time-stratified propensity-score-matched study identified three cohorts of women aged ≥50 in 2010-2018: imminent subsequent fracture within two years of their index fracture (F2); index fracture with no fracture two years prior (F1); and without fractures (F0). Consultation counts by staff roles (CPRD), specialty (SIDIAP, IQVIA-DA and IQVIA-LPD), and visit types (IPCI) were extracted and costs estimated based on local tariffs. The impact of first (F1 vs. F0) and subsequent fractures (F2 vs. F1) was described between the matched cohorts.

RESULTS: For F1 vs. F0, data from 343,573 and 1,096,675 women, respectively, were used across all databases. For F2 vs F1, samples comprised a total of 97,750 and 316,451.

Number of consultations per woman per year was consistently higher for F1 compared to matched-F0, with ratios of the medians being 1.21(CPRD), 1.28(IPCI), 1.30(SIDIAP), 3.20(IQVIA-DA), and 2.80(IQVIA-LPD). Mean costs per woman per year were higher for F1, with increases ranging from €27 (IQVIA-LPD, €95 vs. €68) to €243 (IQVIA-DA, €628 vs. €385).

Number of consultations for F2 were higher than matched-F1, with ratios of the medians being 1.08(CPRD), 1.17(IPCI), 1.08(SIDIAP), 1.35(IQVIA-DA), and 1.39(IQVIA-LPD). Mean costs were higher for F2, except for IQVIA-LPD: between -€3 per woman per year (IQVIA-LPD €95 vs. €91) and €72 (IQVIA-DA, €708 vs. €636).

CONCLUSIONS: Fragility fractures are associated with an increased number of primary care consultations and associated costs, with imminent subsequent fractures generally furthering this burden. This is the first multi-country European study describing resource utilisation and costs amongst postmenopausal women with fractures using data mapped to OMOP-CDM.