title: Impact of compliance and persistence with bisphosphonate therapy on health care costs and utilization.
abstract: 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.
authors: Laurel Highlands Ob/Gyn, PC, 1142 National Pike Road, Hopwood, PA 15445, USA. sunyecz@menopauserx.com
authors: J A
authors: JA
authors: Sunyecz
authors: L
authors: L
authors: Mucha
authors: O
authors: O
authors: Baser
authors: C E
authors: CE
authors: Barr
authors: M M
authors: MM
authors: Amonkar
mesh_terms: 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
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates