The economics of fragility fractures in West Virginia

Compared to the United States, West Virginia has a higher proportion of residents aged 60 or older. This situation creates a stronger risk factor for osteoporosis and subsequent fragility fractures. The widespread availability of bone densitometry screening to identify osteoporosis and the marketing of effective agents to reduce fractures in the past decade has resulted in cost savings. We estimated the absolute number of fragility fractures associated with osteoporosis in West Virginia and projected their costs over a 5-year period. Cost savings were based on the variables of the proportion of osteoporotic patients identified and their long-term adherence to prescribed calcium,vitamin D, and bisphosphonate therapy. Our results indicate that only a small amount of potential cost savings (varying between less than 0.5% to 3.0%) is currently realized through diagnosis and adherence to prescribed treatment. We conclude that increased screening and recognition of osteoporosis by the primary care provider is a more feasible strategy to improve cost savings and fracture reduction rather than attempts to improve treatment adherence.