Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2021

01-12-2021 | Osteoporosis | Original Article

Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in Japan: a simulation projection model from 2020 to 2040

Authors: Hiroshi Hagino, Micah Jackson, Matthew Gitlin, Zachary Wessler

Published in: Archives of Osteoporosis | Issue 1/2021

Login to get access

Abstract

Summary

Impact of increased osteoporosis diagnosis and treatment among postmenopausal women (PMW) on reduction in fractures and associated costs in Japan from 2020 to 2040 was modeled.

Introduction

Japan is currently home to the world’s oldest population and the 65 + years demographic is expected to grow to 35% by 2040. Thus, identifying strategies to reduce clinical and economic burden associated with osteoporosis among this at-risk population is critical.

Methods

A microsimulation model was developed to project osteoporotic annual fracture incidence and costs among PMW 2020–2040. Fracture risk was estimated using a simplified Fracture Risk Assessment Tool (FRAX). Fracture estimates were based on annualized FRAX risk and treatment impact. Published literature informed inputs for direct and indirect fracture costs, DXA screening costs, and treatment costs and efficacy. Japan’s current screening and treatment rates were compared against 50% increases to (1) case finding (screening rate and subsequent treatment rate) and (2) treatment rate among those at highest fracture risk.

Results

From 2020 to 2040, 21.6 million fractures are projected costing US $410.2 billion. Increased case finding scenario resulted in the prevention of 456.9 thousand primary and 340.9 thousand second + fractures saving US $4.25 billion. Increased treatment scenario led to 500.5 thousand and 435.5 thousand fewer primary and second + fractures, respectively, and reduced economic burden by $3.1 billion.

Conclusion

Improvements to rates of osteoporosis screening and preventive treatment in Japan’s aging population through disease awareness campaigns and post-fracture care programs, among others, will likely reduce osteoporosis-associated clinical and economic burden.
Literature
1.
Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, Ohta H, Shiraki M, Sugimoto T, Suzuki T, Soen S, Nishizawa Y, Hagino H, Fukunaga M, Fujiwara S (2012) Japanese 2011 guidelines for prevention and treatment of osteoporosis–executive summary. Arch Osteoporos 7(1–2):3–20CrossRef
2.
Yamauchi M, Sugimoto T (2015) [On "2015 Guidelines for prevention and treatment of osteoporosis". Medical treatment for osteoporosis]. Clin Calcium 25(9): 1285–92.
3.
Fujiwara S, Zhao X, Teoh C, Jaffe DH, Taguchi Y (2019) Disease burden of fractures among patients with osteoporosis in Japan: health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and economic costs. J Bone Miner Metab 37(2):307–318CrossRef
4.
5.
Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, Sakata K (2016) Hip fracture incidence in Japan: estimates of new patients in 2012 and 25-year trends. Osteoporos Int 27(5):1777–1784CrossRef
6.
Hagino H, Furukawa K, Fujiwara S, Okano T, Katagiri H, Yamamoto K, Teshima R (2009) Recent trends in the incidence and lifetime risk of hip fracture in Tottori Japan. Osteoporos Int 20(4):543–548CrossRef
7.
Taguchi Y, Inoue Y, Kido T, Arai N (2018) Treatment costs and cost drivers among osteoporotic fracture patients in Japan: a retrospective database analysis. Arch Osteoporos 13(1):45CrossRef
8.
9.
Nishizawa Y, Miura M, Ichimura S, Inaba M, Imanishi Y, Shiraki M, Takada J, Chaki O, Hagino H, Fukunaga M, Fujiwara S, Miki T, Yoshimura N, Ohta H (2019) Executive summary of the Japan osteoporosis society guide for the use of bone turnover markers in the diagnosis and treatment of osteoporosis (2018 edition). Clin Chim Acta, 498: 101–107
10.
Nishizawa Y, Ohta H, Miura M, Inaba M, Ichimura S, Shiraki M, Takada J, Chaki O, Hagino H, Fujiwara S, Fukunaga M, Miki T, Yoshimura N (2013) Guidelines for the use of bone metabolic markers in the diagnosis and treatment of osteoporosis (2012 edition). J Bone Miner Metab 2013. 31(1): 1–15
11.
Kanazawa I, Inaba M, Inoue D, Uenishi K, Saito M, Shiraki M, Suzuki A, Takeuchi Y, Hagino H, Fujiwara S, Sugimoto T (2020) Executive summary of clinical practice guide on fracture risk in lifestyle diseases. J Bone Miner Metab
12.
Sato M, Vietri J, Flynn JA, Fujiwara S (2014) Treatment for osteoporosis among women in Japan: associations with patient characteristics and patient-reported outcomes in the 2008–2011 Japan national health and wellness surveys. J Osteoporos 2014:909153–909153CrossRef
13.
Kamatari M, Koto S, Ozawa N, Urao C, Suzuki Y, Akasaka E, Yanagimoto K, Sakota K (2007) Factors affecting long-term compliance of osteoporotic patients with bisphosphonate treatment and QOL assessment in actual practice: alendronate and risedronate. J Bone Miner Metab 25(5):302–309CrossRef
14.
Hagino H, Wada T (2019) Osteoporosis liaison service in Japan. Osteoporosis and sarcopenia 5(3):65–68CrossRef
15.
16.
Fujiwara S, Hamaya E, Goto W, Masunari N, Furukawa K, Fukunaga M, Nakamura T, Miyauchi A, Chen P (2011) Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk in Japan. Bone 49(3):520–525CrossRef
17.
Tachiki T, Kouda K, Dongmei N, Tamaki J, Iki M, Kitagawa J, Takahira N, Sato Y, Kajita E, Fujita Y, Yura A, Kagamimori S (2019) Muscle strength is associated with bone health independently of muscle mass in postmenopausal women: the Japanese population-based osteoporosis study. J Bone Miner Metab 37(1):53–59CrossRef
18.
Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90(1):14–21CrossRef
19.
Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27(5):620–628CrossRef
20.
National Health Insurance Price List. Tokyo, Japan: Jihou Press; Japanese. 2019
21.
Fujiwara S, Miyauchi A, Hamaya E, Nicholls RJ, Weston A, Baidya S, Pinto L, Barron R, Takada J (2018) Treatment patterns in patients with osteoporosis at high risk of fracture in Japan: retrospective chart review. Arch Osteoporos 13(1):34CrossRef
22.
Orimo H, Sato M, Kimura S, Wada K, Chen X, Yoshida S, Crawford B (2017) Understanding the factors associated with initiation and adherence of osteoporosis medication in Japan: an analysis of patient perceptions. Osteoporosis and Sarcopenia 3(4):174–184CrossRef
23.
Kanis JA, Cooper C, Hiligsmann M, Rabenda V, Reginster JY, Rizzoli R (2011) Partial adherence: a new perspective on health economic assessment in osteoporosis. Osteoporos Int 22(10):2565–2573CrossRef
24.
Ström O, Borgström F, Kanis JA, Jönsson B (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20(1):23–34CrossRef
25.
Freemantle N, Cooper C, Diez-Perez A, Gitlin M, Radcliffe H, Shepherd S, Roux C (2013) Results of indirect and mixed treatment comparison of fracture efficacy for osteoporosis treatments: a meta-analysis. Osteoporos Int 24(1):209–217CrossRef
26.
Barrionuevo P, Kapoor E, Asi N, Alahdab F, Mohammed K, Benkhadra K, Almasri J, Farah W, Sarigianni M, Muthusamy K, Al Nofal A, Haydour Q, Wang Z, MH Murad (2019) Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis. J Clin Endocrinol Metab, 104(5): 1623–1630
27.
Pike CT, Birnbaum HG, Schiller M, Swallow E, Burge RT, Edgell ET (2011) Prevalence and costs of osteoporotic patients with subsequent non-vertebral fractures in the US. Osteoporos Int 22(10):2611–2621CrossRef
28.
Mori T, Crandall CJ, Ganz DA (2017) Cost-effectiveness of denosumab versus oral alendronate for elderly osteoporotic women in Japan. Osteoporos Int 28(5):1733–1744CrossRef
29.
Iihara N, Ohara E, Bando Y, Yoshida T, Ohara M, Kirino Y (2019) Fragility fractures in older people in Japan based on the national health insurance claims database. Biol Pharm Bull 42(5):778–785CrossRef
30.
Weaver J, Sajjan S, Lewiecki EM, Harris ST, Marvos P (2017) Prevalence and cost of subsequent fractures among U.S. patients with an incident fracture. J Manag Care Spec Pharm 23(4): 461–471
31.
Moriwaki K, Noto S (2017) Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. Osteoporos Int 28(2):621–632CrossRef
32.
Choi SH, Kim D-Y, Koo JW, Lee SG, Jeong S-Y, Kang C-N (2020) Incidence and management trends of osteoporotic vertebral compression fractures in South Korea: a nationwide population-based study. Asian spine journal 14(2):220–228CrossRef
33.
King AB, Saag KG, Burge RT, Pisu M, Goel N (2005) Fracture reduction affects medicare economics (FRAME): impact of increased osteoporosis diagnosis and treatment. Osteoporos Int 16(12):1545–1557CrossRef
34.
Lewiecki EM, Ortendahl JD, Vanderpuye-Orgle J, Grauer A, Arellano J, Lemay J, Harmon AL, Broder MS, Singer AJ (2019) Healthcare policy changes in osteoporosis can improve outcomes and reduce costs in the United States. JBMR Plus, 3(9): e10192
35.
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475CrossRef
36.
Konnopka A, Jerusel N, König HH (2009) The health and economic consequences of osteopenia- and osteoporosis-attributable hip fractures in Germany: estimation for 2002 and projection until 2050. Osteoporos Int 20(7):1117–1129CrossRef
Metadata
Title
Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in Japan: a simulation projection model from 2020 to 2040
Authors
Hiroshi Hagino
Micah Jackson
Matthew Gitlin
Zachary Wessler
Publication date
01-12-2021
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2021
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-021-01019-z

Other articles of this Issue 1/2021

Archives of Osteoporosis 1/2021 Go to the issue

Review

Correlation of oxidative stress-related biomarkers with postmenopausal osteoporosis: a systematic review and meta-analysis

Original Article

Incidence of fractures in women in the post-menopause: a cohort study in primary care in southern Brazil

Original Article

Interactive effect of sarcopenia and falls on vertebral osteoporotic fracture in patients with rheumatoid arthritis

Review

People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis

Correction

Correction to: Delivering fracture prevention services to rural US veterans through telemedicine: a process evaluation

Original Article

Assessment of site-specific X-ray procedure codes for fracture ascertainment: a registry-based cohort study