OBJECTIVES: To describe the adherence for different treatment regimens of oral bisphosphonates (oBP) in osteoporosis patients in Germany. METHODS: Analyses used IMS® Disease Analyser database (contains representative information on approximately 11 million patients from office-based physicians). Osteoporosis patients with a history of malignant diseases, any anticancer or cytostatic hormone prescriptions, Paget’s disease or AIDS were excluded. Eligible osteoporosis patients had data available at least 1-year before and after starting oBP treatment between Dec 2004 and Nov 2007. Compliance was measured as Medical Possession Ratio (MPR); defined as the ratio of prescribed to assumed number of therapy units. MPR >80% assumed compliance. MPR was calculated for patients on therapy for a maximum of 2 years. RESULTS: Data from 4,738 patients were analyzed: 4147 (87.5%) women, 4130 (87.2%) older than 60 years. A total of 177 (3.7%) received daily, 4367 (92.2%) weekly and 194 (4.1%) monthly oBP treatment. The mean MPR was 0.66 (daily), 0.83 (weekly) and 0.84 (monthly) in the oBP treatment period. In total, only 51% of patients had an MPR>80%. Overall, 72% patients discontinued/switched oBP regimen during the first year: 90.4% (daily), 71.6% (weekly) and 70.6% (monthly). CONCLUSIONS: The majority of patients were receiving weekly oBP therapy. Compliance varied for the different treatment regimens, but was particularly poor in patients receiving daily oBP treatment. In addition, a high proportion of patients discontinued/switched oBP regimens during the first year. This study provides further evidence of poor adherence in patients with osteoporosis receiving oBP therapy.