OBJECTIVES : To investigate the epidemiology, treatment patterns, and economic burden of postmenopausal osteoporosis (PMOP) and associated fractures in China in 2017 China health insurance database.

METHODS : The 2017 China Health Insurance Research Association Claims Database (CHIRA) were used for this analysis, with 6.97 million basic medical insurance enrollees, of whom, 1.45 million were women over 50-year-old. Patients with osteoporosis diagnosis were identified among women aged 50+ years old in the database and being considered as PMOP for the analysis. For PMOP patients, their treatment patterns were defined as the proportions of patients receiving different treatment. Healthcare utilization and associated direct medical costs were used to quantify the economic burden of osteoporosis. For patients with osteoporotic fracture, their economic burden was defined by the incremental change of monthly cost between pre-fracture and post-fracture.

RESULTS : A total of 24,026 PMOP patients were identified, 1.65% of all women over 50 years old in the database. Among them, 19.63% and 39.66% of PMOP patients were prescribed with none osteoporosis-related drug and only basic treatment drugs (calcium or vitamin D) respectively. And 40.71% were prescribed with at least one anti-osteoporosis drug, 28.22% of whom were treated with bisphosphonates. The annual all-cause direct cost of PMOP patients was RMB18,718.25, 70.83% of which was reimbursed by health insurance. Among all PMOP patients, 13.50% were identified with osteoporotic fracture, of whom, 56.13% were treated with hospitalization. The mean incremental cost for fracture patients in the first post-fracture month was RMB13,598.80.

CONCLUSIONS : The management of PMOP patients in China were suboptimal and the direct cost were substantially increased after osteoporotic fracture.