title: The direct and indirect costs of the chronic management of osteoporosis: a prospective follow-up of 3440 active subjects.
abstract: BACKGROUND
  The objective of this study was to estimate the direct and indirect costs attributable to osteoporosis (OP) from a societal and a payer's perspective among active subjects living in Belgium and employed in the public workforce.
  
  
  METHODS
  A cohort of 3440 subjects employed by the Liege City Council was followed for 6 months. The City Council employees were invited to fill a monthly log of the data related to their utilization of health resources (contacts with health professionals, medical examinations, drug use,...) due to OP. Information on work disability (number of days of sick leave) and on informal care (number of days off work incurred by active subjects in helping relatives or friends suffering from OP) was also collected.
  
  
  RESULTS
  Of those asked to participate in the study, 1,811 subjects filled in at least one questionnaire. The mean duration of follow-up was 3.46 months. Self-reported prevalence of OP at inclusion was 5.3%. OP subjects were significantly older (52.7+/-6.1 years) than normal subjects (45.5+/-9.8 years) (p<0.05) and included more women (85.3 vs. 55.9%). Direct costs came to 44.6 euros per OP patient-month: 10.9 euros was spent on contact with health professionals, 19.0 euros on medical examinations, 12.1 euros on drugs and 2.6 euros on hospitalizations. During this 6-month study, a total of 140 days of sick leave was recorded (mean: 0.4 per OP patient-month). From a payer's perspective, this loss in productivity yielded a mean cost of 34.05 euros per OP patient-month. A mean number of days off work of 0.018 per active subject-month, attributable to informal care, was recorded. These days of inactivity represented, for the employer, a mean cost of 1.8 euros per active subject-month.
  
  
  CONCLUSIONS
  The results of this survey of a large sample of active subjects confirm that OP-related expenditures, both for medical care and for loss of productivity, are significant.
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, CHU, Bât. B23, 4000 Liege, Belgium. veronique.rabenda@ulg.ac.be
authors.forename: V
authors.initials: V
authors.lastname: Rabenda
authors.forename: C
authors.initials: C
authors.lastname: Manette
authors.forename: R
authors.initials: R
authors.lastname: Lemmens
authors.forename: A-M
authors.initials: AM
authors.lastname: Mariani
authors.forename: N
authors.initials: N
authors.lastname: Struvay
authors.forename: J-Y
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D011446:Prospective Studies; D017150:Public Sector; D018582:Sick Leave / Q000706:statistics & numerical data