Updated 1-Year Fracture Incidence and Costs of Fragility Fractures in US Post-Fracture Patients Based on Commercial Claims Databases
Author(s)
Eric J. Yeh, MSc, PhD1, Sarah Vititoe, MPH2, Michele McDermott, MD3;
1Amgen Inc., Global Health Economics & Outcomes Research, Thousand Oaks, CA, USA, 2Amgen Inc., Center for Observational Research, Thousand Oaks, CA, USA, 3Amgen Inc., Global Clinical Development, Thousand Oaks, CA, USA
1Amgen Inc., Global Health Economics & Outcomes Research, Thousand Oaks, CA, USA, 2Amgen Inc., Center for Observational Research, Thousand Oaks, CA, USA, 3Amgen Inc., Global Clinical Development, Thousand Oaks, CA, USA
Presentation Documents
OBJECTIVES: Osteoporosis-related fractures are associated with significant clinical and economic burden. This study aimed to update the 1-year incidence and costs (up to 2 years) of fractures in patients following an incident fracture in the US.
METHODS: This retrospective observational cohort study used US claims data (Optum Clinformatics Data Mart) from January 01, 2007, to December 31, 2023. Patients aged ≥50 years with an initial (index) fracture during 2022 and ≥3 months of follow-up were included. Patients with prior fracture(s) (all available history), Paget’s disease, or metastatic cancer at baseline were excluded. Study outcomes were stratified by sex, age, and type of index fracture and included 1-year fracture incidence rates per 1,000 person-years (P1000PY) and osteoporosis/fracture-related direct medical costs at 6-month (M) intervals following an incident fracture. Costs (2024 USD) consisted of inpatient (IP), skilled nursing facilities or rehabilitation (SNF/Rehab), outpatient (OP), professional, pharmacy (Rx), and ancillary; outliers beyond 3 standard deviations were trimmed.
RESULTS: We identified 243,220 patients. One-year rates P1000PY of the first subsequent fracture were: hip=45.9, vertebral=60.4, and non-hip non-vertebral (NHNV)=84.2. Mean costs of all, hip, hospitalized vertebral, NHNV, and all vertebral fractures were: 6M pre-fracture baseline=$697, $573, $889, $539, $966; M1-6=$24,950, $56,051, $41,283, $22,606, $14,244; M7-12=$1,995, $2,480, $3,148, $1,465, $2,512; M13-18=$1,626, $2,046, $2,515, $1,164, $2,133; and M19-24=$1,408, $1,915, $2,330, $1,097, $1,947, respectively. Of total costs within 12M, IP, SNF/Rehab, OP, and Rx accounted for: hip=59%, 19%, 10%, 0.3%; hospitalized vertebral=62%, 14%, 12%, 0.6%; NHNV=39%, 13%, 30%, 0.6%; vertebral=49%, 11%, 23%, 2.4%, respectively. In general, total costs in men were higher during M1-6 but lower during M7-24 vs women and higher in patients aged ≥65 vs 50-64 years.
CONCLUSIONS: The clinical and economic burden in post-fracture patients remains significant in 2024 in the US. Osteoporosis medications remained under-utilized and accounted for <2.4% of total healthcare costs.
METHODS: This retrospective observational cohort study used US claims data (Optum Clinformatics Data Mart) from January 01, 2007, to December 31, 2023. Patients aged ≥50 years with an initial (index) fracture during 2022 and ≥3 months of follow-up were included. Patients with prior fracture(s) (all available history), Paget’s disease, or metastatic cancer at baseline were excluded. Study outcomes were stratified by sex, age, and type of index fracture and included 1-year fracture incidence rates per 1,000 person-years (P1000PY) and osteoporosis/fracture-related direct medical costs at 6-month (M) intervals following an incident fracture. Costs (2024 USD) consisted of inpatient (IP), skilled nursing facilities or rehabilitation (SNF/Rehab), outpatient (OP), professional, pharmacy (Rx), and ancillary; outliers beyond 3 standard deviations were trimmed.
RESULTS: We identified 243,220 patients. One-year rates P1000PY of the first subsequent fracture were: hip=45.9, vertebral=60.4, and non-hip non-vertebral (NHNV)=84.2. Mean costs of all, hip, hospitalized vertebral, NHNV, and all vertebral fractures were: 6M pre-fracture baseline=$697, $573, $889, $539, $966; M1-6=$24,950, $56,051, $41,283, $22,606, $14,244; M7-12=$1,995, $2,480, $3,148, $1,465, $2,512; M13-18=$1,626, $2,046, $2,515, $1,164, $2,133; and M19-24=$1,408, $1,915, $2,330, $1,097, $1,947, respectively. Of total costs within 12M, IP, SNF/Rehab, OP, and Rx accounted for: hip=59%, 19%, 10%, 0.3%; hospitalized vertebral=62%, 14%, 12%, 0.6%; NHNV=39%, 13%, 30%, 0.6%; vertebral=49%, 11%, 23%, 2.4%, respectively. In general, total costs in men were higher during M1-6 but lower during M7-24 vs women and higher in patients aged ≥65 vs 50-64 years.
CONCLUSIONS: The clinical and economic burden in post-fracture patients remains significant in 2024 in the US. Osteoporosis medications remained under-utilized and accounted for <2.4% of total healthcare costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE347
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)