OBJECTIVES

Osteoporosis (OP) is a skeletal disease that manifests as bone mineral density loss and low-trauma fractures. This database analysis describes the characteristics of untreated OP patients, their rate of fractures, health resource utilization and cost burden.

METHODS

From the InGef database (2011-2016), eligible patients (>=70 years) untreated for OP were identified via a recorded diagnosis of OP (ICD-10 codes M80/M81) or an initial fragility fracture (index point). All patients were followed up for fractures post index. Direct costs included inpatient, outpatient, pharmacy and ancillary care costs.

RESULTS

144,752 patients (mean age 78 years; 73% female, median follow-up of 3.2 years) met the eligibility criteria; 23% had a history of fractures. 48% of patients had cardiac diseases, 32% diabetes and 27% cerebrovascular disease. 30% (43,514) of patients had at least one post-index fracture; common post-index site-specific fractures were: femoral (10%), vertebral (12%), forearm (12%). Two or more post-index fractures were experienced in 7% (10,262) of patients. Median time from index date to 1^st fracture was 145.5 days and 1^st to 2^nd fracture was 270.5 days. 15% (21,879), and 1% (1,658) of patients were hospitalized for fracture-specific and non-fracture OP care. Median number of all-cause admissions and outpatient visits were 2 and 13 per patient, respectively. Median length of hospital stay per patient for fractures and non-OP related stays were 12 and 17 days, respectively. During follow-up, 24% (34,762) of patients died, 11% (5,446) patients initiated OP treatment and 1% (1,929) were lost to follow-up due to other reasons. OP care and fragility fractures directly contributed to a cost burden of €300 million.

CONCLUSIONS

In this representative cohort (5%) of German patients untreated for OP, the total cost burden of OP care and fragility fractures was €300 million. Such costs may be reduced through systematic OP diagnosis and appropriate treatment strategies.