PMS24 Osteoporosis costs in Italy. Interim results of the block study

OBJECTIVES: Calculate the cost of osteoporosis in postmenopausal women after a fracture-related hospitalization for over a 24 months follow-up period. METHODS: Retrospective analysis of databases of 8 Italian Local Health Units (4 million benefi - ciaries). We included female patients (≥65 years) hospitalized for a typical osteoporotic fracture or osteoporosis between January 1, 2000 and December 31, 2005. Data were collected on hospitalizations, visits, medication and diagnostic tests in the 24 months after the fi rst hospitalization. Over this period, treatment compliance measured as Medical Possession Ratio was calculated according to the proportion of days covered by osteoporosis-related drug treatments and classifi ed as low (≤80%) and high (>80%). Relative unit costs for resource use were collected from DGRS, National Tariffs and Drugs National Formulary. RESULTS: A total of 10,158 patients were included (average age ± SD, 79.0 ± 7.5 years) (overall cost was c70.5 million for the fi rst hospitalization). Of these, 98% (n = 9978) were hospitalized for a typical osteoporotic fracture and 180 (2%) for osteoporosis. Most were hip fractures (5189 (52%); 76% of total costs). During 24 months follow-up, 6654 patients (66%) had resource utilization data (overall cost was c15.0 million; average cost per patient was c2254). Among all 9978 women with fracture, 21% (n = 2119) had a subsequent hospitalization for fracture (66% were hip) and this accounted for 89% of the c15.0 million (11% other, diagnostic tests). Only 15% (n = 1470) of all evaluated patients received osteoporosis-related drug treatment within the six months following discharge and bisphosphonates were prescribed to 92.6% of them. Among bisphosphonate-treated patients, 33% (n = 459) and 66% (n = 921) displayed a high and low compliance level, respectively. CONCLUSIONS: In this database analysis, costs of osteoporosis after a fi rst hospitalization for fracture were relevant and mostly due to re-hospitalization for a new typical osteoporotic fracture, mainly at the hip site. Exposure and compliance to osteoporosis treatment were suboptimal in this patient population.