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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2022

01-12-2022 | Bisphosphonate | Original Article

Prevalence and patterns of anti-osteoporotic drug use based on 2019 real-world nationwide data in Greece

Authors: Maria P. Yavropoulou, Polyzois Makras, Kostas Athanasakis, Vasiliki-Kalliopi Bournia, Konstantinos Mathioudakis, Anastasios Tsolakidis, Eva Kassi, Gregory Kaltsas, Panagiota Mitrou, Petros P. Sfikakis

Published in: Archives of Osteoporosis | Issue 1/2022

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Abstract

Summary

We used the Greek nationwide database to capture individuals on anti-osteoporotic treatment during 2019. From the estimated number of 683,679 osteoporotic individuals, only 42% were receiving treatment, with the total annual cost being almost one-tenth of the total cost of fractures. The treatment gap was significantly higher in males than in females.

Introduction

Based on the 2019 European scorecard (SCOPE), osteoporosis is diagnosed in an estimated 683,679 individuals in Greece, with the direct cost of incident fractures being €694.7 million, although further relevant real-world data are scarce.

Methods

The e-Government Center for Social Security Services prescription database, which covers almost 100% of the Greek population, was used to capture all individuals on anti-osteoporotic treatment during 2019.

Results

A total of 288,983 among 8,641,341 people, corresponding to 3.3% of the total adult Greek population, had filled at least one anti-osteoporotic prescription (6.0% and 0.36% for females and males, respectively). Prevalence of anti-osteoporotic treatment increased with age, from 0.15% in those younger than 50 to 8.6% in those older than 70 years. Oral bisphosphonates were more frequently prescribed (58.8%), followed by denosumab (39.4%). Alendronate was more frequently prescribed in males and in people younger than 60 years. Denosumab was more frequently prescribed in females and in people older than 60 years. Selective estrogen-receptor modulators, teriparatide, and parenteral bisphosphonates accounted for 1.1%, 1.0%, and 0.02% of all prescriptions, respectively. Orthopedic surgeons (39.6%), endocrinologists (19.6%), general practitioners (19%), and rheumatologists (9.3%) prescribed the vast majority of anti-osteoporotic regimens, with significant differences in prescription patterns. The annual cost of treatment per patient increased significantly with age, being on average €323.33.

Conclusions

Less than half of the estimated number of individuals with osteoporosis in 2019 in Greece received treatment, with the total annual cost being far less than the estimated cost of incident-fragility fractures. The impact of this undertreatment on related health care costs merits further investigation.
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Literature
1.
Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefPubMedPubMedCentral
2.
Lyritis GP, Rizou S, Galanos A, Makras P (2013) Incidence of hip fractures in Greece during a 30-year period: 1977–2007. Osteoporos Int 24:1579–1585CrossRefPubMed
3.
Makras P, Vaiopoulos G, Lyritis GP, Greek National Medicine A (2012) 2011 guidelines for the diagnosis and treatment of osteoporosis in Greece. J Musculoskelet Neuronal Interact 12:38–42PubMed
4.
Makras P, Anastasilakis AD, Antypas G et al (2019) The 2018 Guidelines for the diagnosis and treatment of osteoporosis in Greece. Arch Osteoporos 14:39CrossRefPubMed
5.
Makras P, Athanasakis K, Boubouchairopoulou N, Rizou S, Anastasilakis AD, Kyriopoulos J, Lyritis GP (2015) Cost-effective osteoporosis treatment thresholds in Greece. Osteoporos Int 26:1949–1957CrossRefPubMed
6.
Svedbom A, Hernlund E, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA, IOF EURPo, (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137CrossRefPubMedPubMedCentral
7.
Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, McCloskey EV, Willers C, Borgstrom F (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos 16:82CrossRefPubMedPubMedCentral
8.
Willers C, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, McCloskey EV, Borgstrom F, Kanis JA, Srpot IOF (2022) Osteoporosis in Europe: a compendium of country-specific reports. Arch Osteoporos 17:23CrossRefPubMedPubMedCentral
9.
Charonis A, Kyriopoulos II, Spanakis M, Zavras D, Athanasakis K, Pavi E, Kyriopoulos J (2017) Subjective social status, social network and health disparities: empirical evidence from Greece. Int J Equity Health 16:40CrossRefPubMedPubMedCentral
10.
McCloskey E, Rathi J, Heijmans S et al (2021) The osteoporosis treatment gap in patients at risk of fracture in European primary care: a multi-country cross-sectional observational study. Osteoporos Int 32:251–259CrossRefPubMed
11.
Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475CrossRefPubMed
12.
13.
Briot K, Roux C, Thomas T et al (2018) 2018 update of French recommendations on the management of postmenopausal osteoporosis. Joint Bone Spine 85:519–530CrossRefPubMed
14.
Kanis JA, Cooper C, Rizzoli R, Reginster JY, Scientific Advisory Board of the European Society for C, Economic Aspects of O, the Committees of Scientific A, National Societies of the International Osteoporosis F (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44CrossRefPubMed
15.
Diez-Perez A, Adachi JD, Agnusdei D et al (2012) Treatment failure in osteoporosis. Osteoporos Int 23:2769–2774CrossRefPubMed
16.
Fahrleitner-Pammer A, Papaioannou N, Gielen E et al (2017) Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium. Arch Osteoporos 12:58CrossRefPubMedPubMedCentral
17.
Chenot R, Scheidt-Nave C, Gabler S, Kochen MM, Himmel W (2007) German primary care doctors’ awareness of osteoporosis and knowledge of national guidelines. Exp Clin Endocrinol Diabetes 115:584–589CrossRefPubMed
18.
Lespessailles E, Cotte FE, Roux C, Fardellone P, Mercier F, Gaudin AF (2009) Prevalence and features of osteoporosis in the French general population: the Instant study. Joint Bone Spine 76:394–400CrossRefPubMed
19.
Sahota O, Worley A, Hosking DJ (2000) An audit of current clinical practice in the management of osteoporosis in Nottingham. J Public Health Med 22:466–472CrossRefPubMed
20.
Lionis C, Symvoulakis EK, Markaki A, Vardavas C, Papadakaki M, Daniilidou N, Souliotis K, Kyriopoulos I (2009) Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review. Int J Integr Care 9:e88CrossRefPubMedPubMedCentral
21.
22.
Merrill RM, Fowers R (2019) To what extent does sex, age and BMI impact medical and pharmacy costs? A retrospective cohort study involving employees in a large school district in the USA. BMJ Open 9:e024078CrossRefPubMedPubMedCentral
23.
Cho H, Byun JH, Song I, Kim HY, Ha YC, Kim TY, Lee YK, Jang S (2018) Effect of improved medication adherence on health care costs in osteoporosis patients. Medicine (Baltimore) 97:e11470CrossRefPubMed
24.
Marcellusi A, Rotundo MA, Nardone C, Sciattella P, Gazzillo S, Rossini M, Barbagallo M, Antenori A, Valle D, Mennini FS (2020) Osteoporosis: economic burden of disease in Italy. Clin Drug Investig 40:449–458CrossRefPubMed
25.
Tarride JE, Adachi JD, Brown JP, Schemitsch E, Slatkovska L, Burke N (2021) Incremental costs of fragility fractures: a population-based matched -cohort study from Ontario, Canada. Osteoporos Int 32:1753–1761CrossRefPubMedPubMedCentral
26.
Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381CrossRefPubMed
27.
Liatis S, Dafoulas GE, Kani C, Politi A, Litsa P, Sfikakis PP, Makrilakis K (2016) The prevalence and treatment patterns of diabetes in the Greek population based on real-world data from the nation-wide prescription database. Diabetes Res Clin Pract 118:162–167CrossRefPubMed
28.
Sfikakis PP, Bournia VK, Sidiropoulos P et al (2017) Biologic treatment for rheumatic disease: real-world big data analysis from the Greek country-wide prescription database. Clin Exp Rheumatol 35:579–585PubMed
29.
Bournia VK, Tektonidou MG, Vassilopoulos D, Laskari K, Panopoulos S, Fragiadaki K, Mathioudakis K, Tsolakidis A, Mitrou P, Sfikakis PP (2020) Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease. RMD Open 6:e001303
30.
Bournia VK, Fragoulis GE, Mitrou P, Mathioudakis K, Tsolakidis A, Konstantonis G, Vourli G, Paraskevis D, Tektonidou MG, Sfikakis PP (2021) All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015–2019. RMD Open 7(3):e001694
31.
Eisenberg DF, Placzek H, Gu T, Krishna A, Tulsi BB (2015) Cost and consequences of noncompliance to oral bisphosphonate treatment. J Manag Care Spec Pharm 21:56–65PubMed
32.
Sharman Moser S, Yu J, Goldshtein I, Ish-Shalom S, Rouach V, Shalev V, Modi A, Chodick G (2016) Cost and consequences of nonadherence with oral bisphosphonate therapy: findings from a real-world data analysis. Ann Pharmacother 50:262–269CrossRefPubMed
Metadata
Title
Prevalence and patterns of anti-osteoporotic drug use based on 2019 real-world nationwide data in Greece
Authors
Maria P. Yavropoulou
Polyzois Makras
Kostas Athanasakis
Vasiliki-Kalliopi Bournia
Konstantinos Mathioudakis
Anastasios Tsolakidis
Eva Kassi
Gregory Kaltsas
Panagiota Mitrou
Petros P. Sfikakis
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01126-5

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