Summary: Prior national cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. Based on a random population-based sample of older adults, the US medical cost of osteoporosis and fractures is estimated at $22 billion in 2008.
Introduction: National cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. We sought to characterize prevalence and costs for osteoporosis using a random population-based sample of older adults.
Methods: A cross-sectional estimate of medical cost was made with 2002 data from the Medicare Current Beneficiary Survey (MCBS). MCBS combines health interviews with claims information from all payers to profile a random sample of 12,700 Medicare recipients. Three cohorts aged 65 or over were defined: (1) patients experiencing a fracture-related claim in 2002; (2) patients with a diagnosis, medication, or self-report for osteoporosis or past hip fracture; and (3) non-case controls. The total cost of patient claims was compared to that of controls using multiple regression.
Results: Of 30.2 million elderly Medicare recipients in 2002, 1.6 million (5%) were treated for a fracture that year, and an additional 7.2 million (24%) have osteoporosis without a fracture. The estimated mean impact of fractures on annual medical cost was $8,600 (95% confidence interval, $6,400 to $10,800), implying a US cost of $14 billion ($10 to $17 billion). Half of the non-fracture osteoporosis patients received drug treatment, averaging $500 per treated patient, or $2 billion nationwide.
Conclusions: The annual cost of osteoporosis and fractures in the US elderly was estimated at $16 billion, using a national 2002 population-based sample. This amount corroborates previous estimates based on substantially different methodologies. Projected to 2008, the national cost of osteoporosis and fractures was $22 billion.
|1997||Ray NF, Chan JK, Thamer M, Melton LJ III. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. January 1997;12(1):24-35.|
|1992||Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK; The Study of Osteoporotic Fractures Research Group. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res. April 1992;7(4):449-456.|
|2007||Burge R, Dawson‐Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis‐related fractures in the United States, 2005–2025. J Bone Miner Res. March 2007;22(3):465-475.|
|1989||Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Survival experience of aged hip fracture patients. Am J Public Health. March 1989;79(3):274-278.|
|2020||Dash AS, Agarwal S, McMahon DJ, Cosman F, Nieves J, Bucovsky M, Guo XE, Shane E, Stein EM. Abnormal microarchitecture and stiffness in postmenopausal women with isolated osteoporosis at the 1/3 radius. Bone. March 2020;132:115211.|
|2020||Chermside-Scabbo CJ, Harris TL, Brodt MD, Braenne I, Zhang B, Farber CR, Silva MJ. Old mice have less transcriptional activation but similar periosteal cell proliferation compared to young‐adult mice in response to in vivo mechanical loading. J Bone Miner Res. September 2020;35(9):1751-1764.|
|2021||Colaianni G, Errede M, Sanesi L, Notarnicola A, Celi M, Zerlotin R, Storlino G, Pignataro P, Oranger A, Pesce V, Tarantino U, Moretti B, Grano M. Irisin correlates positively with BMD in a cohort of older adult patients and downregulates the senescent marker p21 in osteoblasts. J Bone Miner Res. February 2021;36(2):305-314.|
|2018||Morton JJ, Bennison M, Lievers WB, Waldman SD, Pilkey AK. Failure behaviour of rat vertebrae determined through simultaneous compression testing and micro-CT imaging. J Mech Behav Biomed Mater. March 2018;79:73-82.|
|2020||Lopez-Olivo MA, des Bordes JKA, Lin H, Rizvi T, Volk RJ, Suarez-Almazor ME. Comparison of multimedia and printed patient education tools for patients with osteoporosis: a 6-month randomized controlled trial. Osteoporos Int. May 2020;31(5):857-866.|
|2020||Nayak S, Greenspan SL. Cost-effectiveness of five versus ten years of alendronate treatment prior to drug holiday for women with osteoporosis. Osteoporos Int. July 2020;31(7):1273-1282.|
|2019||Maynard RD. Establishing the Functional Role of Cped1 in the Genetic Regulation of the Osteoblast Rochester, NY: University of Rochester; 2019.|
|2016||Chen C. Mechanical and Micro-Structural Modeling of Trabecular Bone by in Vivo Imaging [PhD thesis]. Iowa City, IA: University of Iowa; December 2016.|
|2016||Jones DA. Reference Point Indentation of Human Trabecular Bone Treated With Bisphosphonates for Varying Durations [Master's thesis]. Lexington; KY: University of Kentucky; 2016.|
|2013||Mecke D. Probabilistic Analysis of the Microstructure of Human Trabecular Bone With High and Low Volume Fractions [Master's thesis]. San Antionio, TX: University of Texas at San Antonio; December 2013.|
|2016||Meyer LA. Testing and Modeling Mechanical Properties of Ex Vivo Trabecular Bone [PhD thesis]. Madison, WI: University of Wisconsin; 2016.|