Current and Future Incidence and Costs of Osteoporosis-Related Fractures in The Netherlands: Combining Claims Data with BMD Measurements

• Published in: Calcified tissue international Vol. 98; no. 3; pp. 235 - 243
• Main Authors: Lötters, Freek J. B., van den Bergh, Joop P., de Vries, Frank, Rutten-van Mölken, Maureen P. M. H.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2016; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Aged; Aged, 80 and over; Biochemistry; Biomedical and Life Sciences; Bone Density; Cell Biology; Costs; Demography; Endocrinology; Female; Fractures; Health Care Costs; Hip Fractures - epidemiology; Humans; Incidence; Life Sciences; Male; Middle Aged; Netherlands - epidemiology; Original Research; Orthopedics; Osteoporosis; Osteoporosis - economics; Osteoporosis - epidemiology; Osteoporotic Fractures - economics; Osteoporotic Fractures - epidemiology; Sex Factors; Spinal Fractures - epidemiology; Studies; Netherlands; Osteoporosis; Costs; Fractures; Future projections; Incidence
• ISSN: 0171-967X; 1432-0827
• DOI: 10.1007/s00223-015-0089-z

This study aims to estimate the incidence and costs of osteoporosis-related fractures in The Netherlands in 2010 and project them to 2030. The incidence and costs of five different types of fractures (spine, hip, upper extremity, lower extremity, wrist/distal forearm, other) were derived from claims data of all Dutch healthcare insurers. Given that fracture-codes in claims data do not indicate whether fractures are related to osteoporosis, we used a large dataset with DXA measurements to attribute fractures to osteoporosis. Future projections used four scenarios: (1) demographic, (2) demographic + annual trend in incidence rates, (3) demographic + annual trend in incidence rates + annual trend in costs, and (4) treatment. Of all registered fractures, 32 % was attributed to osteoporosis (36 % in women and 21 % in men). Over time (2010–2030) the increase in incidence of osteoporosis-related fractures was estimated to be 40 % (scenario 1); for the hip 60–79 % (scenario 1–2). In 2010, approximately €200 million was spent on treatment of osteoporosis-related fractures, most on fractures of the hip followed by wrist/distal forearm. In both men and women, the excess costs due to osteoporosis-related fractures were highest for hip fractures (€11,000–€13,000 per person), followed by spine fractures (€6000–€7000).The costs for osteoporosis-related fractures were projected to increase with 50 % from 2010 to 2030 (scenario 1); for the hip 60–148 % (scenario 1–3). Pharmacotherapeutic prevention can lead to cost-savings of €377 million in 2030 (scenario 1 and 4 combined). The projected increase in incidence and costs of osteoporosis-related fractures calls for a wider use of prevention and treatment.