ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2013
Association between refill compliance to oral bisphosphonate treatment, incident fractures, and health care costs--an analysis using national health databases.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Association of orthogeriatric care models with evaluation and treatment of osteoporosis: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Meta-analysis for the efficacy of bisphosphonates on hip fracture prevention.Journal of bone and mineral metabolism · 2020Pooled it
- Real-world persistence and adherence with oral bisphosphonates for osteoporosis: a systematic review.BMJ open · 2019Pooled it
- Pooled it
- Denosumab or Zoledronic Acid in Postmenopausal Women With Osteoporosis Previously Treated With Oral Bisphosphonates.The Journal of clinical endocrinology and metabolism · 2016Trial
- Antiresorptive Use and Risk of Hip Fracture in Older Women with Osteoporosis: Findings from a Real-World National Database of 21,332 Women.Journal of clinical medicine · 2026Article
- Adherence to anti-osteoporotic therapy and five-year survival after fragility hip fracture: prognostic value of the MADiT stratification tool within a fracture liaison service.Archives of osteoporosis · 2026Observational
- Improving High-Risk Osteoporosis Medication Adherence and Safety With an Automated Dashboard.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Time-varying exposure to anti-osteoporosis drugs and risk of first-time hip fracture: a population wide study within the Norwegian Epidemiologic Osteoporosis Studies (NOREPOS).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Explaining declining hip fracture rates in Norway: a population-based modelling study.The Lancet regional health. Europe · 2023Article
- Short-term efficacy and safety of zoledronate acid or denosumab in Japanese patients with postmenopausal osteoporosis.Journal of bone and mineral metabolism · 2021Article
- Does treatment with bisphosphonates protect against fractures in real life? The HUNT study, Norway.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Alendronate medication possession ratio and the risk of second hip fracture: an 11-year population-based cohort study in Taiwan.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Effect of improved medication adherence on health care costs in osteoporosis patients.Medicine · 2018Observational
- Women's lived experiences of learning to live with osteoporosis: a longitudinal qualitative study.BMC women's health · 2017Article
- Subjects with osteoporosis to remain at high risk for fracture despite benefit of prior bisphosphonate treatment-a Danish case-control study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Cost and health care resource use associated with noncompliance with oral bisphosphonate therapy: an analysis using Danish health registries.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Article
- Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study.The American journal of medicine · 2015Article
- Risk factors for fracture among current, persistent users of bisphosphonates.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Article
- Epidemiology of forearm fractures in adults in Denmark: national age- and gender-specific incidence rates, ratio of forearm to hip fractures, and extent of surgical fracture repair in inpatients and outpatients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
summaryThe study estimates the cost of poor and suboptimal refill compliance by estimating fracture costs and assessing the association between refill compliance with oral bisphosphonates and incident fractures using Danish health registers. Patients with poor and suboptimal refill compliance had more major osteoporotic fractures, and the direct costs related to hospital care, primary care, and pharmaceutical treatment for these excess fractures reached almost 14 M DKK (2.5 M USD) for the study population which compares to a national annual excess cost of around 17 M DKK (3.1 M USD) using 2011 prescription prevalence.
introductionAdherence to oral anti-osteoporosis treatment has been shown in several studies to be relatively low and the potential impact on fracture burden is high. The aim of the study was to assess the association between refill compliance and all-cause health care costs.
methodsA national dataset was extracted with all treatment-naive patients who began oral bisphosphonate (BP) treatment for osteoporosis in Denmark between 1997 and 2006 (N = 54,876, 87 % women). Patients who survived for at least 2 years (N = 47,176) were divided into groups based on Medication Possession Ratio (MPR). Logistic regressions were used to derive difference in the probability of incident fractures between the three MPR groups. Fracture costs (related to medication use, primary care practice, specialists, and hospitals) were derived by comparing cost 12 months before and after fracture.
resultsFor alendronate, the adjusted risk of major osteoporotic fractures was significantly reduced (OR 0.768; 0.686-0.859), including fractures of the hip (0.718; 0.609-0.846) and humerus (0.54; 0.431-0.677) with MPR ≥ 0.8. The risk reduction was lower with etidronate. Over 2 years, a total of 171 hip fractures and 53 other major osteoporotic fractures were attributed to suboptimal or poor refill compliance, with an excess cost of 13.7 M DKK (2.5 M USD).
conclusionsPoor refill compliance is not unusual in patients on oral bisphosphonates, and we demonstrate that this is accompanied by excess major osteoporotic fractures and health care costs at the societal level.
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