title: Gender inequalities in the treatment of osteoporosis.
abstract: BACKGROUND
  Our aim was to perform both gender- and age-specific analysis regarding the utilisation of anti-osteoporotic drugs in Hungary, between 2007 and 2011, and to compare our results with other European countries.
  
  
  METHODS
  The database of the Hungarian National Health Insurance Fund was screened for anti-osteoporotic medications, covering 100% of the Hungarian population (10 million people). ICD coding system (International Classification of Diseases) and WHO ATC/DDD methodology were used for medication screening and analysis.
  
  
  RESULTS
  In Hungary, the total bisphosphonate use was 6.66 DDD/TID (Defined Daily Dose/1000 inhabitants/day) in 2007, and 6.22 DDD/TID in 2011; the rate of bisphosphonate combinations slightly increased from 1.60 to 2.81 DDD/TID. The total vitamin D use almost doubled (13.73 DDD/TID in 2011), while the calcium supplementation tripled (4.47 DDD/TID in 2011), and so did the strontium ranelate utilisation (0.70 DDD/TID in 2011) within the investigated time period. Denosumab consumption was marginal. Male patients were disproportionately, 10-20 times undertreated in all age groups, and treatment choice was restricted among men. Several differences were seen in our results compared to those in Baltic countries, Finland and in Norway.
  
  
  CONCLUSIONS
  Men were significantly undertreated in all age groups, compared to women. The 10 to 20-fold difference calls attention to this unrecognised problem.
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary. Electronic address: andrea.bor@pharm.u-szeged.hu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bor
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary.
authors.forename: Mária
authors.initials: M
authors.lastname: Matuz
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary.
authors.forename: Nóra
authors.initials: N
authors.lastname: Gyimesi
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Biczók
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary.
authors.forename: Gyöngyvér
authors.initials: G
authors.lastname: Soós
authors.affiliation: University of Szeged, Faculty of Pharmacy, Department of Clinical Pharmacy, Szikra utca 8, 6725 Szeged, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Doró
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000627:therapeutic use; D016208:Databases, Factual; D000069448:Denosumab / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004363:Drug Utilization; D005060:Europe; D005260:Female; D005387:Finland; D054625:Healthcare Disparities; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D009664:Norway; D010024:Osteoporosis / Q000188:drug therapy*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013876:Thiophenes / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D004164:Diphosphonates; D013876:Thiophenes; C081587:strontium ranelate; D014807:Vitamin D; D000069448:Denosumab
keywords: Bisphosphonates; Drug utilization; Hip fracture; Osteoporosis; Sex-specific differences