Pharmaco-economic issues in the treatment of severe osteoporosis.

INTRODUCTION clinical guidelines recommend to identify and treat people at high risk of fracture. METHODS we have carried out a simulation concerning pharmaco-economic issues in the treatment of severe osteoporosis and particularly those people with previous femoral fragility fractures, assuming that only 13.1% of hip fractured patients had started a proper antifracture therapy, as shown by the analysis of the Tuscany regional database. RESULTS Annual costs sustained by the Italian healthcare system for treating hip fractured patients all over Italy have been estimated to range from 2 560 000 in year 2000 to 3 291 750 in year 2005, representing only 0,3% of the overall costs sustained because of hip fractures in Italy. CONCLUSIONS Sixty percent of the pharmacological costs can be considered as ineffective from a therapeutic point of view because patients were assuming their drugs only for 6 months. There is a need for specific codification of osteoporotic fragility fractures at hospital admissions and for implementing regional strategies aimed to reduce hip re-fractures by increasing the number of patients on treatment and incrementing adherence to treatment.

[1]  C. Cooper,et al.  European guidance for the diagnosis and management of osteoporosis in postmenopausal women , 2008, Osteoporosis International.

[2]  A. Distante,et al.  Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey , 2007, Osteoporosis International.

[3]  O. Svensson,et al.  Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial , 2006, Acta orthopaedica.

[4]  A. Silman,et al.  The prevalence of vertebral deformity in European men and women: The european vertebral osteoporosis study , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  N. Latham,et al.  Pattern of functional change during rehabilitation of patients with hip fracture. , 2006, Archives of physical medicine and rehabilitation.

[6]  S. Giannini,et al.  The effect of age, weight, and lifestyle factors on calcaneal quantitative ultrasound: the ESOPO study , 2003, Osteoporosis International.

[7]  S. K. Brenneman,et al.  The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50–99: results from the National Osteoporosis Risk Assessment (NORA) , 2006, Osteoporosis International.

[8]  L. Melton,et al.  The worldwide problem of osteoporosis: insights afforded by epidemiology. , 1995, Bone.

[9]  A. Distante,et al.  Hip fractures in Italy: 2000–2005 extension study , 2010, Osteoporosis International.

[10]  M. Di Monaco,et al.  Muscle Mass and Functional Recovery in Men with Hip Fracture , 2007, American journal of physical medicine & rehabilitation.

[11]  W. O'Fallon,et al.  Fracture Incidence in Olmsted County, Minnesota: Comparison of Urban with Rural Rates and Changes in Urban Rates Over time , 1999, Osteoporosis International.

[12]  S. Zimmerman,et al.  The Lower Extremity Gain Scale: a performance-based measure to assess recovery after hip fracture. , 2006, Archives of physical medicine and rehabilitation.

[13]  R. Monaco,et al.  Muscle Mass and Functional Recovery in Women with Hip Fracture , 2006, American journal of physical medicine & rehabilitation.

[14]  J. Peipert,et al.  Screening for Osteoporosis in Postmenopausal Women: Recommendations and Rationale , 2002, Annals of Internal Medicine.

[15]  H. Meyer,et al.  Factors Associated with Mortality after Hip Fracture , 2000, Osteoporosis International.

[16]  M. Parker,et al.  Mortality and morbidity after hip fractures. , 1993, BMJ.

[17]  B. Jönsson,et al.  The societal burden of osteoporosis in Sweden. , 2007, Bone.