Dispensing anti-osteoporotic drugs changed during the COVID-19 pandemic

Kocijan, Roland<sup>1,2</sup>; Stockinger, Theresa<sup>1,2</sup>; Haschka, Judith<sup>1</sup>; Reichardt, Berthold<sup>3</sup>; Resch, Heinrich<sup>2,4</sup>; Zwerina, Jochen<sup>1</sup>; Behanova, Martina<sup>1</sup>

Affiliations

¹Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria

²Sigmund Freud University Vienna, School of Medicine, Metabolic Bone Diseases Unit, Vienna, Austria

³Austrian Social Health Insurance Fund, Österreichische Gesundheitskasse, Eisenstadt, Austria

⁴St. Vincent Hospital Vienna, 2nd Department of Internal Medicine, Austria

Abstract and keywords

Objectives: Caring for osteoporosis patients has proven challenging during the COVID-19 pandemic due to repeated lockdowns in Austria. The distinct possibility of insufficient treatment regimens is therefore a matter of pressing concern. The aim of the study was to assess alterations in dispensing anti-osteoporotic drugs during the COVID-19 pandemic.

Patients/methods: This study was a nationwide retrospective register-based observational study which included all patients in Austria aged ≥50 who received at least one prescription for anti-osteoporotic medication between January 2016 and November 2020. Pseudonymised individual-level patients' data were obtained from social insurance authorities. Anti-osteoporotic agents were divided into: (i) oral bisphosphonates, (ii) intravenous bisphosphonates, (iii) selective estrogen receptor modulators (SERMs), (iv) teriparatide (TPTD) and (v) denosumab (DMAB). We used interrupted time series analysis with autoregressive integrated moving average models (ARIMA) to predict drug dispensing.

Results: There were 2,884,374 dispensations of anti-osteoporotic drugs to 224,598 patients between 2016 and 2020. The mean monthly prescriptions for oral bisphosphonates (−14.5 %) and SERMs (−12.9 %) decreased during the COVID-19 pandemic when compared to the non-COVID-19 period. Dispensing for intravenous bisphosphonates (1.7 %) and teriparatide (9.5 %) increased. Prescriptions for DMAB decreased during the first lock-down, however increased by 29.1 % for the total observation time.

The Arima models showed that in March 2020 (beginning of the 1st COVID-19 lockdown), there was a decrease of 778 dispensings, with a further increase of 14 dispensings every month for denosumab; a decrease by 178 dispensings, with a further increase of 23 dispensings every month for zolendronic acid; a decrease by 2950 dispensings, but with a further increase of 236 dispensings every other month for ibandronate and a decrease by 1443 dispensing with a further decrease of 29 dispensings for alendronate than predicted, had the lockdown not occurred.

Conclusions: The total number of prescriptions dispensed to patients treated with anti-osteoporotic medications declined rapidly during first COVID-19 lockdown. The observed decrease of DMAB during the first lockdown rebounded in the following months. Considering the massive treatment gap for osteoporosis, and the related fracture risk, clinicians should continue treatment, even during a pandemic.

Keywords: COVID-19; Anti-osteoporotic therapy; Lockdown; Osteoporosis; Autoregressive integrated moving average models; Dispensing; Austria

Links

DOI: 10.1016/j.bone.2022.116477

PubMed: 35779846

WoS: 000826578400004

History

Received: 2022-04-8

Revised: 2022-05-27

Accepted: 2022-06-25

Online: 2022-06-29

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Cited By (1)

Year	Entry
2024	Liu Y, Arora T, Zhang J, Sodhi SK, Xie F, Curtis JR. The interruption of romosozumab treatment during COVID lockdown among US post-menopausal women enrolled in Medicare. Bone. January 2024;178:116954.