Characteristics of patients initiating teriparatide for the treatment of osteoporosis.
The demographic and clinical characteristics of patients initiating teriparatide were compared with those of patients initiating bisphosphonates for the treatment of osteoporosis. In these samples of commercially insured, Medicare, and Medicaid patients, patients initiating teriparatide were older, in poorer health, and appeared to have more severe osteoporosis than patients initiating bisphosphonates.


BACKGROUND
The demographic and clinical characteristics of patients initiating teriparatide are compared with those of patients initiating bisphosphonates.


METHODS
Beneficiaries (45 years and older) with at least one claim for teriparatide or a bisphosphonate from 2003 to 2005 and continuous enrollment in the previous 12 months and subsequent 6 months were identified from commercial, Medicare, and Medicaid administrative claims databases. Patients initiating teriparatide (commercial/Medicare (N = 2,218); Medicaid (N = 824)) were compared to patients initiating bisphosphonates (commercial/Medicare (N = 97,570); Medicaid (N = 77,526)) in terms of age, provider specialty, comorbidities, prior use of osteoporosis medications, fractures, BMD screening, health status, and resource utilization.


RESULTS
Teriparatide patients were older and in poorer health than bisphosphonate patients. Approximately 38% of teriparatide patients in both groups had fractured in the pre-period compared to 16% of commercial/Medicare and 15% of Medicaid bisphosphonate patients. Teriparatide patients were more likely to have used osteoporosis medications in the pre-period (79.9% versus 32.1% (commercial/Medicare); 82.2% versus 19.6% (Medicaid)).


CONCLUSIONS
In these samples of patients, those initiating teriparatide differed from those initiating bisphosphonates. Teriparatide patients were older, in poorer health, and appeared to have more severe osteoporosis than bisphosphonate patients. Comparisons of treatment outcomes should take these differences in patient characteristics into consideration.
Foster
S A
SA
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA. fostersa@lilly.com
Foley
K A
KA
Meadows
E S
ES
Johnston
J A
JA
Wang
S
S
Pohl
G M
GM
Long
S R
SR
D000367:Age Factors; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000208:ethnology; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000208:ethnology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019379:Teriparatide / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide
J Clin Epidemiol. 1992 Feb;45(2):197-203
1573438
Pharmacoeconomics. 1999 Jul;16(1):1-8
10539118
Obstet Gynecol. 2004 Jan;103(1):203-16
14704265
N Engl J Med. 2001 May 10;344(19):1434-41
11346808
J Clin Epidemiol. 1992 Jun;45(6):613-9
1607900