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- Title
Cost and Consequences of Nonadherence With Oral Bisphosphonate Therapy: Findings From a Real-World Data Analysis.
- Authors
Sharman Moser, Sarah; Yu, Jingbo; Goldshtein, Inbal; Ish-Shalom, Sofia; Rouach, Vanessa; Shalev, Varda; Modi, Ankita; Chodick, Gabriel
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>To examine the association between adherence with oral bisphosphonate therapy and fracture risk as well as health care resource utilization.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
BONE fracture prevention; DIPHOSPHONATES; HOSPITAL care; DRUGS; MEDICAL care; OSTEOPOROSIS; PATIENT compliance; COST analysis; RETROSPECTIVE studies; ECONOMICS
- Publication
Annals of Pharmacotherapy, 2016, Vol 50, Issue 4, p262
- ISSN
1060-0280
- Publication type
journal article
- DOI
10.1177/1060028015626935