OBJECTIVES : To estimate the medication use, clinical outcomes and economic burden of postmenopausal women with prevalent osteoporosis (OP) in China.

METHODS : Data were obtained from Urban Employee Basic Medical Insurance database (2015-2017) in Tianjin, China. Postmenopausal female patients (aged ≥ 50 years) with OP were identified through diagnoses of OP, diagnoses of osteoporotic fractures, or prescriptions of specific anti-OP drugs in 2017. Patients with OP-related records in 2015-2016 were further identified as prevalent and included for analysis. Medication use including bisphosphonates, raloxifene, calcitonin, estrogens, calcium and vitamin D, and active vitamin D was investigated. Clinical outcomes were investigated through the incidence of osteoporotic fractures stratified by age. All-cause and OP-related health care resource utilization and direct medical costs were also estimated in 2017.

RESULTS : A total of 16,193 patients with prevalent OP were identified. Only 35.9% of them were treated with anti-OP drugs, and bisphosphonates was the most commonly used drug (11.1%). 4.0% of patients experienced ≥ 1 fracture, and the incidence of fractures increased with age (50-59 years: 1.8%, 60-69 years: 3.8%, 70-79 years: 6.0%, ≥ 80 years: 6.6%). 99.8% of patients experienced ≥ 1 outpatient visit with the mean visits of 40.1 in 2017, and 58.0% of outpatient visits were OP-related. 20.6% of patients experienced ≥ 1 hospitalization with the mean length of stay of 10.3 days and the mean costs of CNY 14,685 per admission, and 8.9% of the hospitalizations were OP-related. The annual mean all-cause costs were CNY 14,392 per patient, with a mean cost of CNY 22,754 for inpatients and CNY 9,727 for outpatients.

CONCLUSIONS : The poor medication use, suboptimal clinical outcomes and considerable economic burden highlight the importance of effective strategies for the prevention and management in OP in China.