title: Current and Future Incidence and Costs of Osteoporosis-Related Fractures in The Netherlands: Combining Claims Data with BMD Measurements.
abstract: This study aims to estimate the incidence and costs of osteoporosis-related fractures in The Netherlands in 2010 and project them to 2030. The incidence and costs of five different types of fractures (spine, hip, upper extremity, lower extremity, wrist/distal forearm, other) were derived from claims data of all Dutch healthcare insurers. Given that fracture-codes in claims data do not indicate whether fractures are related to osteoporosis, we used a large dataset with DXA measurements to attribute fractures to osteoporosis. Future projections used four scenarios: (1) demographic, (2) demographic + annual trend in incidence rates, (3) demographic + annual trend in incidence rates + annual trend in costs, and (4) treatment. Of all registered fractures, 32 % was attributed to osteoporosis (36 % in women and 21 % in men). Over time (2010-2030) the increase in incidence of osteoporosis-related fractures was estimated to be 40 % (scenario 1); for the hip 60-79 % (scenario 1-2). In 2010, approximately €200 million was spent on treatment of osteoporosis-related fractures, most on fractures of the hip followed by wrist/distal forearm. In both men and women, the excess costs due to osteoporosis-related fractures were highest for hip fractures (€11,000-€13,000 per person), followed by spine fractures (€6000-€7000).The costs for osteoporosis-related fractures were projected to increase with 50 % from 2010 to 2030 (scenario 1); for the hip 60-148 % (scenario 1-3). Pharmacotherapeutic prevention can lead to cost-savings of €377 million in 2030 (scenario 1 and 4 combined). The projected increase in incidence and costs of osteoporosis-related fractures calls for a wider use of prevention and treatment.
authors.affiliation: Institute of Medical Technology Assessment, Erasmus University, P.O.-Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: Freek J B
authors.initials: FJ
authors.lastname: Lötters
authors.affiliation: Maastricht University Medical Center+, Maastricht, The Netherlands.|VieCuri Medical Center Noord Limburg, Venlo, The Netherlands.
authors.forename: Joop P
authors.initials: JP
authors.lastname: van den Bergh
authors.affiliation: VieCuri Medical Center Noord Limburg, Venlo, The Netherlands.|Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, The Netherlands.|MRC Epidemiology Lifecourse Unit, Southampton General Hospital, Southampton, UK.|Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: de Vries
authors.affiliation: Institute of Medical Technology Assessment, Erasmus University, P.O.-Box 1738, 3000 DR, Rotterdam, The Netherlands. m.rutten@bmg.eur.nl.
authors.forename: Maureen P M H
authors.initials: MP
authors.lastname: Rutten-van Mölken
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003710:Demography; D005260:Female; D017048:Health Care Costs; D006620:Hip Fractures / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010024:Osteoporosis / Q000191:economics / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000191:economics* / Q000453:epidemiology*; D012737:Sex Factors; D016103:Spinal Fractures / Q000453:epidemiology
keywords: Costs; Fractures; Future projections; Incidence; Osteoporosis