Skip to main content
Top
Published in: Archives of Osteoporosis 1/2017

Open Access 01-12-2017 | Original Article

Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States

Authors: Emily Durden, Lionel Pinto, Lorena Lopez-Gonzalez, Paul Juneau, Richard Barron

Published in: Archives of Osteoporosis | Issue 1/2017

Login to get access

Abstract

Summary

This retrospective, observational study assessed 2-year persistence and compliance by treatment, route of administration, and dosing frequency in postmenopausal women initiating a new osteoporosis therapy. Two-year persistence and compliance rates were higher in women receiving injectables compared with oral agents.

Purpose

This study extends previous studies limited to 1-year follow-up by examining persistence with osteoporosis therapies over a 2-year period and compares short- and long-term trends in persistence and compliance among postmenopausal women with commercial or Medicare supplemental insurance in the USA.

Methods

This retrospective, observational cohort study enrolled women ≥50 years newly initiating osteoporosis therapy between January 1 and December 31, 2012 (i.e., the index date), with continuous enrollment ≥14 months before and ≥24 months after their index date. Persistence (continuous therapy without a >60-day gap) and compliance with the index therapy were evaluated at 2 years of follow-up. Multivariable logistic regression was used to compare the odds of persistence and compliance across treatment and dosing regimens.

Results

This study included 43,543 patients with mean (standard deviation) age 65 (10) years. At 2 years of follow-up, persistence and compliance were higher for patients treated with injectable agents (ranging from 34 to 41%, excluding an every-3-month injection) than those treated with oral agents (ranging from 20 to 31%). Additionally, patients initiating oral bisphosphonates (except risedronate once daily), raloxifene (daily), or zoledronic acid (annually) had significantly lower odds of persistence compared with denosumab (every 6 months).

Conclusions

Patients initiating injectable therapies had greater persistence and compliance at 2 years than those initiating oral therapies. Patients initiating an every-6-month injection had significantly higher persistence compared with those initiating more frequently dosed (e.g., daily and weekly) oral or injectable agents.
Literature
6.
go back to reference Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, Silverman S (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022. doi:10.4065/81.8.1013 CrossRefPubMed Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, Silverman S (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022. doi:10.​4065/​81.​8.​1013 CrossRefPubMed
7.
go back to reference Cheng LI, Durden E, Limone B, Radbill L, Juneau PL, Spangler L, Mirza FM, Stolshek BS (2015) Persistance and compliance with osteroporosis therapies among women in a commercially insured population in the United States. J Manag Care Spec Pharm 21:824–833 833aCrossRefPubMed Cheng LI, Durden E, Limone B, Radbill L, Juneau PL, Spangler L, Mirza FM, Stolshek BS (2015) Persistance and compliance with osteroporosis therapies among women in a commercially insured population in the United States. J Manag Care Spec Pharm 21:824–833 833aCrossRefPubMed
8.
go back to reference Karlsson L, Lundkvist J, Psachoulia E, Intorcia M, Strom O (2015) Persistence with denosumab and persistence with oral bisphosphonates for the treatment of postmenopausal osteoporosis: a retrospective, observational study, and a meta-analysis. Osteoporos Int 26:2401–2411. doi:10.1007/s00198-015-3253-4 CrossRefPubMedPubMedCentral Karlsson L, Lundkvist J, Psachoulia E, Intorcia M, Strom O (2015) Persistence with denosumab and persistence with oral bisphosphonates for the treatment of postmenopausal osteoporosis: a retrospective, observational study, and a meta-analysis. Osteoporos Int 26:2401–2411. doi:10.​1007/​s00198-015-3253-4 CrossRefPubMedPubMedCentral
10.
go back to reference Imaz I, Zegarra P, Gonzalez-Enriquez J, Rubio B, Alcazar R, Amate JM (2010) Poor bisphosphonate adherence for treatment of osteoporosis increases fracture risk: systematic review and meta-analysis. Osteoporos Int 21:1943–1951. doi:10.1007/s00198-009-1134-4 CrossRefPubMed Imaz I, Zegarra P, Gonzalez-Enriquez J, Rubio B, Alcazar R, Amate JM (2010) Poor bisphosphonate adherence for treatment of osteoporosis increases fracture risk: systematic review and meta-analysis. Osteoporos Int 21:1943–1951. doi:10.​1007/​s00198-009-1134-4 CrossRefPubMed
12.
go back to reference Confavreux CB, Canoui-Poitrine F, Schott AM, Ambrosi V, Tainturier V, Chapurlat RD (2012) Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database. Eur J Endocrinol 166:735–741. doi:10.1530/eje-11-0959 CrossRefPubMed Confavreux CB, Canoui-Poitrine F, Schott AM, Ambrosi V, Tainturier V, Chapurlat RD (2012) Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database. Eur J Endocrinol 166:735–741. doi:10.​1530/​eje-11-0959 CrossRefPubMed
13.
go back to reference Devine J, Trice S, Finney Z, Yarger S, Nwokeji E, Linton A, Davies W (2012) A retrospective analysis of extended-interval dosing and the impact on bisphosphonate compliance in the US Military Health System. Osteoporos Int 23:1415–1424. doi:10.1007/s00198-011-1729-4 CrossRefPubMed Devine J, Trice S, Finney Z, Yarger S, Nwokeji E, Linton A, Davies W (2012) A retrospective analysis of extended-interval dosing and the impact on bisphosphonate compliance in the US Military Health System. Osteoporos Int 23:1415–1424. doi:10.​1007/​s00198-011-1729-4 CrossRefPubMed
14.
16.
go back to reference Wade SW, Curtis JR, Yu J, White J, Stolshek BS, Merinar C, Balasubramanian A, Kallich JD, Adams JL, Viswanathan HN (2012) Medication adherence and fracture risk among patients on bisphosphonate therapy in a large United States health plan. Bone 50:870–875. doi:10.1016/j.bone.2011.12.021 CrossRefPubMed Wade SW, Curtis JR, Yu J, White J, Stolshek BS, Merinar C, Balasubramanian A, Kallich JD, Adams JL, Viswanathan HN (2012) Medication adherence and fracture risk among patients on bisphosphonate therapy in a large United States health plan. Bone 50:870–875. doi:10.​1016/​j.​bone.​2011.​12.​021 CrossRefPubMed
17.
go back to reference Ziller V, Kostev K, Kyvernitakis I, Boeckhoff J, Hadji P (2012) Persistence and compliance of medications used in the treatment of osteoporosis--analysis using a large scale, representative, longitudinal German database. Int J Clin Pharmacol Ther 50:315–322CrossRefPubMed Ziller V, Kostev K, Kyvernitakis I, Boeckhoff J, Hadji P (2012) Persistence and compliance of medications used in the treatment of osteoporosis--analysis using a large scale, representative, longitudinal German database. Int J Clin Pharmacol Ther 50:315–322CrossRefPubMed
18.
go back to reference Freemantle N, Satram-Hoang S, Tang ET, Kaur P, Macarios D, Siddhanti S, Borenstein J, Kendler DL (2012) Final results of the DAPS (Denosumab Adherence Preference Satisfaction) study: a 24-month, randomized, crossover comparison with alendronate in postmenopausal women. Osteoporos Int 23:317–326. doi:10.1007/s00198-011-1780-1 CrossRefPubMed Freemantle N, Satram-Hoang S, Tang ET, Kaur P, Macarios D, Siddhanti S, Borenstein J, Kendler DL (2012) Final results of the DAPS (Denosumab Adherence Preference Satisfaction) study: a 24-month, randomized, crossover comparison with alendronate in postmenopausal women. Osteoporos Int 23:317–326. doi:10.​1007/​s00198-011-1780-1 CrossRefPubMed
19.
go back to reference Kendler DL, McClung MR, Freemantle N, Lillestol M, Moffett AH, Borenstein J, Satram-Hoang S, Yang YC, Kaur P, Macarios D, Siddhanti S (2011) Adherence, preference, and satisfaction of postmenopausal women taking denosumab or alendronate. Osteoporos Int 22:1725–1735. doi:10.1007/s00198-010-1378-z CrossRefPubMed Kendler DL, McClung MR, Freemantle N, Lillestol M, Moffett AH, Borenstein J, Satram-Hoang S, Yang YC, Kaur P, Macarios D, Siddhanti S (2011) Adherence, preference, and satisfaction of postmenopausal women taking denosumab or alendronate. Osteoporos Int 22:1725–1735. doi:10.​1007/​s00198-010-1378-z CrossRefPubMed
22.
go back to reference Silverman SL, Siris E, Kendler DL, Belazi D, Brown JP, Gold DT, Lewiecki EM, Papaioannou A, Simonelli C, Ferreira I, Balasubramanian A, Dakin P, Ho P, Siddhanti S, Stolshek B, Recknor C (2015) Persistence at 12 months with denosumab in postmenopausal women with osteoporosis: interim results from a prospective observational study. Osteoporos Int 26:361–372. doi:10.1007/s00198-014-2871-6 CrossRefPubMed Silverman SL, Siris E, Kendler DL, Belazi D, Brown JP, Gold DT, Lewiecki EM, Papaioannou A, Simonelli C, Ferreira I, Balasubramanian A, Dakin P, Ho P, Siddhanti S, Stolshek B, Recknor C (2015) Persistence at 12 months with denosumab in postmenopausal women with osteoporosis: interim results from a prospective observational study. Osteoporos Int 26:361–372. doi:10.​1007/​s00198-014-2871-6 CrossRefPubMed
23.
go back to reference Hadji P, Claus V, Ziller V, Intorcia M, Kostev K, Steinle T (2012) GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates. Osteoporos Int 23:223–231. doi:10.1007/s00198-011-1535-z CrossRefPubMed Hadji P, Claus V, Ziller V, Intorcia M, Kostev K, Steinle T (2012) GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates. Osteoporos Int 23:223–231. doi:10.​1007/​s00198-011-1535-z CrossRefPubMed
24.
go back to reference Landfeldt E, Strom O, Robbins S, Borgstrom F (2012) Adherence to treatment of primary osteoporosis and its association to fractures—the Swedish Adherence Register Analysis (SARA). Osteoporos Int 23:433–443. doi:10.1007/s00198-011-1549-6 CrossRefPubMed Landfeldt E, Strom O, Robbins S, Borgstrom F (2012) Adherence to treatment of primary osteoporosis and its association to fractures—the Swedish Adherence Register Analysis (SARA). Osteoporos Int 23:433–443. doi:10.​1007/​s00198-011-1549-6 CrossRefPubMed
25.
26.
28.
go back to reference Yood RA, Andrade SE, Mazor KM, Fouayzi H, Chan W, Kahler K (2010) Bone density consequences of initiation and compliance with therapy for osteoporosis. Arthritis Care Res (Hoboken) 62:1440–1445. doi:10.1002/acr.20261 CrossRef Yood RA, Andrade SE, Mazor KM, Fouayzi H, Chan W, Kahler K (2010) Bone density consequences of initiation and compliance with therapy for osteoporosis. Arthritis Care Res (Hoboken) 62:1440–1445. doi:10.​1002/​acr.​20261 CrossRef
Metadata
Title
Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States
Authors
Emily Durden
Lionel Pinto
Lorena Lopez-Gonzalez
Paul Juneau
Richard Barron
Publication date
01-12-2017
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-017-0316-5

Other articles of this Issue 1/2017

Archives of Osteoporosis 1/2017 Go to the issue