Cost and Consequences of Nonadherence With Oral Bisphosphonate Therapy: Findings From a Real-World Data Analysis.

Abstract

BACKGROUND:

Adherence to osteoporosis treatment remains poor despite available treatments and physician and patient education. This study aims to determine the effect of low adherence in real-world data.

OBJECTIVE:

To examine the association between adherence with oral bisphosphonate therapy and fracture risk as well as health care resource utilization.

METHODS:

Women included in this retrospective analysis were 55 years or older and had started oral bisphosphonate therapy between 2005 and 2011 in a large not-for-profit health care center in Israel. Adherence to therapy was measured by the medication possession ratio (MPR) during the first year from therapy initiation. Patients with MPR lower than 70% were considered nonadherent. Study outcomes were osteoporotic fracture events and health care utilization (including physician visits and hospitalizations) during the second year from therapy initiation.

RESULTS:

Among the 17 770 women included in the analysis (mean age = 66.5 years; SD = ±8.3 years), 48.9% were nonadherent to therapy during the first year of treatment. Osteoporotic fracture risks during the second year among adherent and nonadherent patients were 2.1% and 2.5%, respectively (P = 0.1). When analysis was limited to patients 75 years or older, nonadherence with bisphosphonates was associated with an adjusted odds ratio of 1.49 (95% CI = 1.08-2.04) for osteoporotic fractures compared with adherent patients. Nonadherent patients had 13.4% higher medical costs than their adherent counterparts among patients 75 years and older (P = 0.002).

CONCLUSIONS:

In patients 75 years and older, nonadherence with oral bisphosphonates can be associated with significantly greater short-term risk of osteoporotic fractures and higher utilization of health care services.

• Authors: Sarah Sharman Moser, Jingbo Yu, Inbal Goldshtein, Sofia Ish-Shalom, Vanessa Rouach, Varda Shalev, Ankita Modi, Gabriel Chodick
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) Vol. 50 Issue 4 Pg. 262-9 (Apr 2016) ISSN: 1542-6270 [Electronic] United States
• PMID: 26783359 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2016.

Chemical References

• Diphosphonates

Topics

• Aged
• Costs and Cost Analysis
• Diphosphonates (therapeutic use)
• Female
• Fractures, Bone (prevention & control)
• Health Services (statistics & numerical data)
• Hospitalization (economics)
• Humans
• Medication Adherence
• Middle Aged
• Osteoporosis (drug therapy)
• Retrospective Studies