title: Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study.
abstract: BACKGROUND
  To estimate the disability-adjusted life years (DALY) in a nationwide representative sample of postmenopausal women with osteoporosis. The effects of drug-based therapy and risk factors for osteoporotic bone fractures on DALY losses were also explored.
  
  
  METHODS
  DALY were estimated based on participant's clinical characteristics and Health-Related Quality-of-Life (HRQoL) data obtained from a cross-sectional, epidemiological one-visit study (the GINERISK study). The study enrolled postmenopausal women (at least 12-months after their last menstrual period) with osteoporosis, above 18-years old, who attended Spanish outpatient Gynaecology clinics. HRQoL was assessed using the generic SF-12v2 questionnaire, which was used to derive disutility values. Mortality rates were extracted from the Spanish national statistics database. Factors explored to be associated with DALY losses were examined using ANOVA, ANCOVA and MANCOVA models.
  
  
  RESULTS
  DALY could be computed in 2,782 (67%) out of 4,157 postmenopausal women, with a mean (95% CI) age of 61.0 (60.7-61.2) years. Overall individual undiscounted DALY per woman were 6.1 (5.9-6.2), resulting to be significantly higher in women with severe osteoporosis with prior bone fracture; 7.8 (7.2-8.4) compared to osteoporotic women [5.8 (5.6-6.0)] or postmenopausal women with a BMD > -2.5 T-score that received a drug-based therapy [6.2 (5.8-6.5)]; F = 27.0 (P < 0.01). Models explaining the variation in the levels of health based on the use of a selective estrogen receptor modulator (SERM) or possession of risk factors for osteoporotic BF were found (P < 0.05).
  
  
  CONCLUSIONS
  DALY losses were considerable amongst postmenopausal women with osteoporosis. Not having a prior bone fracture, being older, using a SERM and having less osteoporotic risk factors were all linked to less DALY losses.
authors.affiliation: Department of Economics, Universitat de Barcelona, Diagonal 690, 08034, Barcelona, Spain. darba@ub.edu.
authors.forename: Josep
authors.initials: J
authors.lastname: Darbà
authors.affiliation: BCN Health Economics & Outcomes Research S.L., Travessera de Gracia 62, 5-6, 08006, Barcelona, Spain. lisette.kaskens@bcnhealth.com.
authors.forename: Lisette
authors.initials: L
authors.lastname: Kaskens
authors.affiliation: BCN Health Economics & Outcomes Research S.L., Travessera de Gracia 62, 5-6, 08006, Barcelona, Spain. nuria.perez@bcnhealth.com.
authors.forename: Nuria
authors.initials: N
authors.lastname: Pérez-Álvarez
authors.affiliation: Instituto Palacios de Salud y Medicina de la Mujer, Calle Antonio Acuña, 9, 28009, Madrid, Spain. ipalacios@institutopalacios.com.
authors.forename: Santiago
authors.initials: S
authors.lastname: Palacios
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Universitario Cruces, Gran Vía 81-4, 48011, Bilbao, Spain. doctor@neyro.com.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Neyro
authors.affiliation: Health Economics and Outcomes Research Department, Pfizer, S.L.U., Avda. Europa 20B. Parque Empresarial la Moraleja, 28108, Alcobendas, Madrid, Spain. javier.rejas@pfizer.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents