Resource utilization in postmenopausal osteoporosis without incident fractures.
OBJECTIVE
To evaluate the annual utilization and cost incurred by postmenopausal women with osteoporosis in a public tertiary healthcare facility.


METHODS
One hundred consecutive patients with postmenopausal osteoporosis were selected from the Universidade Federal de São Paulo (UNIFESP), Brazil. The socioeconomic and clinical characteristics, quality of life, and resource utilization and costs in the last year were assessed using 3 questionnaires. Each resource used had its unitary cost based on the Public Healthcare System Table of Fees (1998).


RESULTS
The mean age was 66 years and the monthly family income was 456 US dollars (1998). There was a mean of 7 visits/patient/year. Seventy-seven percent of the patients used calcium and 38% used estrogens. There were no incident fractures during the study. The mean total annual cost for osteoporosis treatment, considering the societal perspective, was 775 US dollars (1998) per patient/year.


CONCLUSIONS
The costs of all treatment drugs related and not related to osteoporosis represented 9% of the monthly household income. Among some drugs used, many are lacking evidence of effectiveness, such as shark cartilage. The costs related to transportation were significant, representing 21% of the total directly spent by the patients. Further studies are necessary to rationally drive treatment, based on the best cost-effectiveness strategies of osteoporosis management.
Kowalski
Sérgio Candido
SC
Department of Medicine-Division of Rheumatology, Universidade Federal de São Paulo, São Paulo, Brazil.
Sjenzfeld
Vera Lúcia
VL
Ferraz
Marcos Bosi
MB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005598:Fractures, Spontaneous; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000191:economics* / Q000503:physiopathology / Q000628:therapy; D011788:Quality of Life; D012720:Severity of Illness Index