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Published in: Health Economics Review 1/2012

Open Access 01-12-2012 | Research

Economic burden of osteoporotic fractures in Austria

Authors: Hans Peter Dimai, Kurt Redlich, Monika Peretz, Fredrik Borgström, Uwe Siebert, Jörg Mahlich

Published in: Health Economics Review | Issue 1/2012

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Abstract

Objective

Osteoporotic fractures impose a huge economic burden on society. Though several cost of illness studies from other countries exist, no equivalent study has been conducted in Austria. Our study aims at assessing costs resulting from osteoporotic fractures in Austria in the year 2008 from a societal perspective.

Methods

We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria.

Results

For the year 2008, the total annual financial burden incurred by osteoporotic fractures in Austria amounted to approx. €685.2 million, the largest fraction of which was due to the opportunity cost of family care (30.2%), followed by costs for hospitalization (26.6%).

Conclusions

The financial burden of osteoporotic fractures in Austria is substantial. Our findings may have implications for future economic analyses, and also support health care authorities in their decision making.
Appendix
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Literature
1.
go back to reference Consensus development conference: prophylaxis and treatment of osteoporosis Am J Med 1991,90(1):107–10. Consensus development conference: prophylaxis and treatment of osteoporosis Am J Med 1991,90(1):107–10.
2.
go back to reference Johnell O, Kanis J: Epidemiology of osteoporotic fractures. Osteoporos Int 2005,16(2):S3–7. 10.1007/s00198-004-1702-6PubMedCrossRef Johnell O, Kanis J: Epidemiology of osteoporotic fractures. Osteoporos Int 2005,16(2):S3–7. 10.1007/s00198-004-1702-6PubMedCrossRef
3.
go back to reference Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al.: Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 2011,22(5):1277–88. 10.1007/s00198-011-1601-6PubMedCentralPubMedCrossRef Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al.: Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 2011,22(5):1277–88. 10.1007/s00198-011-1601-6PubMedCentralPubMedCrossRef
4.
go back to reference Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006,17(12):1726–33. 10.1007/s00198-006-0172-4PubMedCrossRef Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006,17(12):1726–33. 10.1007/s00198-006-0172-4PubMedCrossRef
5.
go back to reference Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002,359(9319):1761–7. 10.1016/S0140-6736(02)08657-9PubMedCrossRef Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002,359(9319):1761–7. 10.1016/S0140-6736(02)08657-9PubMedCrossRef
6.
go back to reference Ben Sedrine W, Radican L, Reginster JY: On conducting burden-of-osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center. Rheumatology (Oxford) 2001,40(1):7–14. 10.1093/rheumatology/40.1.7CrossRef Ben Sedrine W, Radican L, Reginster JY: On conducting burden-of-osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center. Rheumatology (Oxford) 2001,40(1):7–14. 10.1093/rheumatology/40.1.7CrossRef
7.
go back to reference Lippuner K, Golder M, Greiner R: Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int 2005,16(Suppl 2):S8–17.PubMedCrossRef Lippuner K, Golder M, Greiner R: Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int 2005,16(Suppl 2):S8–17.PubMedCrossRef
8.
go back to reference Gabriel SE, Tosteson ANA, Leibson CL, Crowson CS, Pond GR, Hammond CS, et al.: Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 2002,13(4):323–30. 10.1007/s001980200033PubMedCrossRef Gabriel SE, Tosteson ANA, Leibson CL, Crowson CS, Pond GR, Hammond CS, et al.: Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 2002,13(4):323–30. 10.1007/s001980200033PubMedCrossRef
9.
go back to reference Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E: Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 2001,12(4):271–8. 10.1007/s001980170116PubMedCrossRef Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E: Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 2001,12(4):271–8. 10.1007/s001980170116PubMedCrossRef
10.
go back to reference Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, et al.: Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 1999,15(5):507–14. 10.2165/00019053-199915050-00008PubMedCrossRef Reginster JY, Gillet P, Ben Sedrine W, Brands G, Ethgen O, de Froidmont C, et al.: Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 1999,15(5):507–14. 10.2165/00019053-199915050-00008PubMedCrossRef
11.
go back to reference Brecht J, Schdlich P: Burden of illness imposed by osteoporosis in Germany. HEPAC Health Economics in Prevention and Care 2000,1(1):26. 10.1007/s101980050006CrossRef Brecht J, Schdlich P: Burden of illness imposed by osteoporosis in Germany. HEPAC Health Economics in Prevention and Care 2000,1(1):26. 10.1007/s101980050006CrossRef
12.
go back to reference Häussler B, Gothe H, Göl D, Glaeske G, Pientka L, Felsenberg D: Epidemiology, treatment and costs of osteoporosis in Germany–the BoneEVA Study. Osteoporos Int 2007,18(1):77–84. 10.1007/s00198-006-0206-yPubMedCrossRef Häussler B, Gothe H, Göl D, Glaeske G, Pientka L, Felsenberg D: Epidemiology, treatment and costs of osteoporosis in Germany–the BoneEVA Study. Osteoporos Int 2007,18(1):77–84. 10.1007/s00198-006-0206-yPubMedCrossRef
13.
go back to reference Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, et al.: Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 2011,22(2):685–92. 10.1007/s00198-010-1271-9PubMedCrossRef Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, et al.: Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 2011,22(2):685–92. 10.1007/s00198-010-1271-9PubMedCrossRef
14.
go back to reference Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL: Methods for the Economic Evaluation of Health Care Programs. 3rd edition. Oxford University Press, Oxford; 2005. Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL: Methods for the Economic Evaluation of Health Care Programs. 3rd edition. Oxford University Press, Oxford; 2005.
15.
go back to reference Johannesson M, Karlsson G: The friction cost method: a comment. J Health Econ 1997,16(2):249–55. 10.1016/S0167-6296(97)00006-4PubMedCrossRef Johannesson M, Karlsson G: The friction cost method: a comment. J Health Econ 1997,16(2):249–55. 10.1016/S0167-6296(97)00006-4PubMedCrossRef
16.
go back to reference Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B: Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 2004,15(2):108–12. 10.1007/s00198-003-1516-yPubMedCrossRef Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B: Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 2004,15(2):108–12. 10.1007/s00198-003-1516-yPubMedCrossRef
17.
go back to reference Garraway WM, Stauffer RN, Kurland LT, O'Fallon WM: Limb fractures in a defined population.II. Orthopedic treatment and utilization of health care. Mayo Clin Proc 1979,54(11):708–13.PubMed Garraway WM, Stauffer RN, Kurland LT, O'Fallon WM: Limb fractures in a defined population.II. Orthopedic treatment and utilization of health care. Mayo Clin Proc 1979,54(11):708–13.PubMed
18.
go back to reference Arden N, Cooper Meunier P, future of osteoporosis: Epidemiology. Osteoporosis 1998. Arden N, Cooper Meunier P, future of osteoporosis: Epidemiology. Osteoporosis 1998.
19.
go back to reference Neill D, Hughes D, Leake A, Morris C, Jones D, Oakley A, et al.: Neuritogenic-neurotoxic effects of membrane-associated forms of amyloid precursor protein. Dement Geriatr Cogn Disord 2001,12(1):40–51. 10.1159/000051234PubMedCrossRef Neill D, Hughes D, Leake A, Morris C, Jones D, Oakley A, et al.: Neuritogenic-neurotoxic effects of membrane-associated forms of amyloid precursor protein. Dement Geriatr Cogn Disord 2001,12(1):40–51. 10.1159/000051234PubMedCrossRef
20.
go back to reference Palvanen M, Kannus P, Niemi S, Parkkari J: Hospital-treated minimal-trauma rib fractures in elderly Finns: long-term trends and projections for the future. Osteoporos Int 2004,15(8):649–53.PubMedCrossRef Palvanen M, Kannus P, Niemi S, Parkkari J: Hospital-treated minimal-trauma rib fractures in elderly Finns: long-term trends and projections for the future. Osteoporos Int 2004,15(8):649–53.PubMedCrossRef
21.
go back to reference Palvanen M, Kannus P, Niemi S, Parkkari J, Vuori I: Epidemiology of minimal trauma rib fractures in the elderly. Calcif Tissue Int 1998,62(3):274–7. 10.1007/s002239900429PubMedCrossRef Palvanen M, Kannus P, Niemi S, Parkkari J, Vuori I: Epidemiology of minimal trauma rib fractures in the elderly. Calcif Tissue Int 1998,62(3):274–7. 10.1007/s002239900429PubMedCrossRef
22.
go back to reference Erstattungskodex-EKO. 1030th edition. Hauptverband der österreichischen Sozialversicherungsträger, Wien; 2008. Erstattungskodex-EKO. 1030th edition. Hauptverband der österreichischen Sozialversicherungsträger, Wien; 2008.
23.
go back to reference Statistik Austria: Arbeitskostenerhebungen 2008. Statistik Austria; 2008. Statistik Austria: Arbeitskostenerhebungen 2008. Statistik Austria; 2008.
24.
go back to reference Miller RE, Blair PB: Input–output Analysis. Foundations and Extentions. Cambridge University Press, New York; 2010. Miller RE, Blair PB: Input–output Analysis. Foundations and Extentions. Cambridge University Press, New York; 2010.
25.
go back to reference Obermayer U, Mayer-Schulz M, Stefanits J: Invaliditätspensionen. In Sozialbericht 2007 – 2008 - Ressortaktivitäten und sozialpolitische Analysen. Bundesministerium für Soziales und Konsumentenschutz, Vienna; 2008. Obermayer U, Mayer-Schulz M, Stefanits J: Invaliditätspensionen. In Sozialbericht 2007 – 2008 - Ressortaktivitäten und sozialpolitische Analysen. Bundesministerium für Soziales und Konsumentenschutz, Vienna; 2008.
26.
go back to reference Borgström F, Sobocki P, Ström O, Jönsson B: The societal burden of osteoporosis in Sweden. Bone 2007,40(6):1602–9. 10.1016/j.bone.2007.02.027PubMedCrossRef Borgström F, Sobocki P, Ström O, Jönsson B: The societal burden of osteoporosis in Sweden. Bone 2007,40(6):1602–9. 10.1016/j.bone.2007.02.027PubMedCrossRef
27.
go back to reference Borgström F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, et al.: Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006,17(5):637–50. 10.1007/s00198-005-0015-8PubMedCrossRef Borgström F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, et al.: Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006,17(5):637–50. 10.1007/s00198-005-0015-8PubMedCrossRef
28.
go back to reference Pike MM, Barnes MA, Barron RW: The role of illustrations in children's inferential comprehension. J Exp Child Psychol 2010,105(3):243–55. 10.1016/j.jecp.2009.10.006PubMedCrossRef Pike MM, Barnes MA, Barron RW: The role of illustrations in children's inferential comprehension. J Exp Child Psychol 2010,105(3):243–55. 10.1016/j.jecp.2009.10.006PubMedCrossRef
29.
go back to reference Bouza C, López T, Palma M, Amate JM: Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 2007,18(5):649–57. 10.1007/s00198-006-0292-xPubMedCrossRef Bouza C, López T, Palma M, Amate JM: Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 2007,18(5):649–57. 10.1007/s00198-006-0292-xPubMedCrossRef
30.
go back to reference Zethraeus N, Strömberg L, Jönsson B, Svensson O, Ohlén G: The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 1997,68(1):13–7. 10.3109/17453679709003968PubMedCrossRef Zethraeus N, Strömberg L, Jönsson B, Svensson O, Ohlén G: The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 1997,68(1):13–7. 10.3109/17453679709003968PubMedCrossRef
31.
go back to reference Johnell O, Gullberg B, Kanis JA: The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 1997,7(2):138–44. 10.1007/BF01623689PubMedCrossRef Johnell O, Gullberg B, Kanis JA: The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 1997,7(2):138–44. 10.1007/BF01623689PubMedCrossRef
32.
go back to reference Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C: The burden of hospitalised fractures in Sweden. Osteoporos Int 2005,16(2):222–8. 10.1007/s00198-004-1686-2PubMedCrossRef Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C: The burden of hospitalised fractures in Sweden. Osteoporos Int 2005,16(2):222–8. 10.1007/s00198-004-1686-2PubMedCrossRef
33.
go back to reference Cooper C, Campion G, Melton LJ: Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992,2(6):285–9. 10.1007/BF01623184PubMedCrossRef Cooper C, Campion G, Melton LJ: Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992,2(6):285–9. 10.1007/BF01623184PubMedCrossRef
34.
go back to reference Riggs BL, Hartmann LC: Selective estrogen-receptor modulators – mechanisms of action and application to clinical practice. N Engl J Med 2003,348(7):618–29. 10.1056/NEJMra022219PubMedCrossRef Riggs BL, Hartmann LC: Selective estrogen-receptor modulators – mechanisms of action and application to clinical practice. N Engl J Med 2003,348(7):618–29. 10.1056/NEJMra022219PubMedCrossRef
35.
go back to reference Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al.: Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009,361(8):756–65. 10.1056/NEJMoa0809493PubMedCrossRef Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al.: Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009,361(8):756–65. 10.1056/NEJMoa0809493PubMedCrossRef
36.
go back to reference Dimai HP, Pietschmann P, Resch H, Preisinger E, Fahrleitner-Pammer A, Dobnig H, et al.: Austrian guidance for the pharmacological treatment of osteoporosis in postmenopausal women–update 2009. Wien Med Wochenschr Suppl 2009, 122: 1–34.PubMedCrossRef Dimai HP, Pietschmann P, Resch H, Preisinger E, Fahrleitner-Pammer A, Dobnig H, et al.: Austrian guidance for the pharmacological treatment of osteoporosis in postmenopausal women–update 2009. Wien Med Wochenschr Suppl 2009, 122: 1–34.PubMedCrossRef
37.
go back to reference Seeman E, Compston J, Adachi J, Brandi ML, Cooper C, Dawson-Hughes B, et al.: Non-compliance: the Achilles' heel of anti-fracture efficacy. Osteoporos Int 2007,18(6):711–9. 10.1007/s00198-006-0294-8PubMedCrossRef Seeman E, Compston J, Adachi J, Brandi ML, Cooper C, Dawson-Hughes B, et al.: Non-compliance: the Achilles' heel of anti-fracture efficacy. Osteoporos Int 2007,18(6):711–9. 10.1007/s00198-006-0294-8PubMedCrossRef
38.
go back to reference Silverman SL, Gold DT, Cramer JA: Reduced fracture rates observed only in patients with proper persistence and compliance with bisphosphonate therapies. South Med J 2007,100(12):1214–8. 10.1097/SMJ.0b013e31815a9685PubMedCrossRef Silverman SL, Gold DT, Cramer JA: Reduced fracture rates observed only in patients with proper persistence and compliance with bisphosphonate therapies. South Med J 2007,100(12):1214–8. 10.1097/SMJ.0b013e31815a9685PubMedCrossRef
39.
go back to reference Reginster J: Adherence and persistence: impact on outcomes and health care resources. Bone 2006,38(2 Suppl 2):S18–21.PubMedCrossRef Reginster J: Adherence and persistence: impact on outcomes and health care resources. Bone 2006,38(2 Suppl 2):S18–21.PubMedCrossRef
40.
go back to reference Pietschmann P, Azizi-Semrad U, Pils K, Fahrleitner-Pammer A, Resch H, Dobnig H: Pharmacologic undertreatment of osteoporosis in Austrian nursing homes and senior's residences. Wien Klin Wochenschr 2010,122(17–18):532–7.PubMedCrossRef Pietschmann P, Azizi-Semrad U, Pils K, Fahrleitner-Pammer A, Resch H, Dobnig H: Pharmacologic undertreatment of osteoporosis in Austrian nursing homes and senior's residences. Wien Klin Wochenschr 2010,122(17–18):532–7.PubMedCrossRef
Metadata
Title
Economic burden of osteoporotic fractures in Austria
Authors
Hans Peter Dimai
Kurt Redlich
Monika Peretz
Fredrik Borgström
Uwe Siebert
Jörg Mahlich
Publication date
01-12-2012
Publisher
Springer Berlin Heidelberg
Published in
Health Economics Review / Issue 1/2012
Electronic ISSN: 2191-1991
DOI
https://doi.org/10.1186/2191-1991-2-12

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