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Persistent Use of Osteoporosis Medications Pays Off

By Dr. C.H. Weaver M.D.

The persistent use of medications to prevent osteoporosis reduces the risk of fracture and significantly lowers total health care costs according to a recent report published in Osteoporosis International.

Osteoporosis occurs when bones become weak due to loss of bone tissue; osteoporotic bone is thinner and full of holes, and there is less of it. As a result, the bone fractures easily, even due to simple everyday activities like a minor stumble, lifting a child, or even sneezing. Unfortunately, osteoporosis is a “silent disease,” meaning it often exists without any symptoms or warning signs until it is revealed through a bone fracture. A fracture can cause significant pain, loss of independence, and other serious health consequences, including a shorter life expectancy.

Researchers examined data on 294,369 women who were at least 66 years old, insured by Medicare and prescribed osteoporosis medicines for the first time at some point between 2009 and 2011. They defined one third of women as “persistence on medication” meaning they took an osteoporosis medication for at least a year with no gaps in therapy of two months or longer. The remaining two-thirds of women were considered “non-persistent” medication users.

When the researchers compared the women on persistent drugs therapy with those who had stopped taking their medication they found there was a 31% lowering of the fracture rate reduction for persistent users. There was an annual fracture rate that dropped from 16.2 to 4.1 fractures for every 100 patient-years treated in the first 18 months of using osteoporosis drugs.

Total average health costs were lower for persistent users ($14,476 vs. $19,181 a year), as were inpatient hospital costs ($3,516 vs. $6,297) compared for those who did not consistently take their osteoporosis medicines.

How is Osteoporosis Prevented and Treated?

The widespread use of bisphosphonate medications used to treat osteoporosis coincided with a dramatic decline in fractures from the mid-1990s to the mid-2000s. But use of these medicines has declined in recent years following reports of rare, but serious side effects including unusual fractures of the thigh bone, death of bone tissue in the jaw and esophageal cancer. Bisphosphonate use has been replaced by Prolia and other medications to prevent osteoporosis are on the horizon.

New Treatment for Osteoporosis About to Become Available Osteoporosis International, online July 18, 2018.