Impact of compliance and persistence with bisphosphonate therapy on health care costs and utilization.
The impact of persistence and compliance with bisphosphonate therapy on health care costs and utilization was examined in women newly prescribed bisphosphonates. At 3 years, women who were persistent and compliant with bisphosphonate therapy had lower total costs compared with non-persistent and non-compliant women, after controlling for relevant risk factors.


BACKGROUND
The impact of persistence and compliance with bisphosphonate therapy on health care costs and utilization was examined in bisphosphonate-naïve women.


METHODS
Two claims databases were used to identify women > or = 45 years of age and who filled a new bisphosphonate prescription during 2000-2002. Persistence and compliance were evaluated over 3 years. Compliance was defined as a medication possession ratio (days of bisphosphonate supply/days of follow-up) > or = 0.80; persistence was defined as no refill gaps > or = 30 days. Multivariate models accounted for potential confounders.


RESULTS
This analysis included 32,944 women (mean age, 64 years) who filled a new prescription for daily or weekly alendronate (n = 26,581) or risedronate (n = 6,363). At 3 years, 37% of women were compliant and 21% of women were persistent. Unadjusted total mean health care costs were lower for the compliant vs. non-compliant and persistent vs. non-persistent cohorts. After adjusting for potential confounders, total health care costs were reduced by 8.9% for persistent patients (p < 0.001) and 3.5% for compliant patients (p = 0.014). Persistence decreased the likelihood of inpatient admission by 47%.


CONCLUSIONS
At 3 years, women who were persistent and compliant with bisphosphonate therapy had lower total costs compared with non-persistent and non-compliant women, after controlling for relevant risk factors.
Sunyecz
J A
JA
Laurel Highlands Ob/Gyn, PC, 1142 National Pike Road, Hopwood, PA 15445, USA. sunyecz@menopauserx.com
Mucha
L
L
Baser
O
O
Barr
C E
CE
Amonkar
M M
MM
D000368:Aged; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use*; D004164:Diphosphonates / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000191:economics; D010349:Patient Compliance / Q000706:statistics & numerical data*; D014481:United States
D050071:Bone Density Conservation Agents; D004164:Diphosphonates