OBJECTIVES: To examine the association between teriparatide adherence and healthcare utilization and costs in “real world” U.S. kyphoplasty/vertebroplasty (KV) patients. METHODS: A large U.S. administrative claims database was used to identify patients aged 50+ with a KV between January 1, 2002-December 31, 2010 (first observed KV=index). All patients included had 6+ months of pre-index continuous enrollment, and no pre-index teriparatide, cancer, or Paget’s disease. Patients initiating teriparatide were followed for up-to 36 months post-index (follow-up period), with censoring at switch to bisphosphonates, disenrollment, end of study period, or having cancer or Paget’s disease. Three teriparatide adherence (measured as the proportion of days covered [PDC] over the follow-up period) cohorts were constructed: low (PDC≤0.5), medium (0.5