Impact of osteoporosis on high-cost chronic diseases
Sarah W Thayer1, Bradley S Stolshek2, Gabriel Gomez Rey1
1OptumInsight, Eden Prairie, MN, USA.
Insights
Osteoporosis significantly increases healthcare costs for patients with chronic diseases (CDs), especially those with newly diagnosed osteoporosis. This burden highlights the need for integrated care management strategies.
Area of Science:
- Gerontology
- Public Health
- Health Economics
Background:
- Osteoporosis poses a significant health burden, particularly in aging populations.
- Chronic diseases (CDs) like cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), depression, and diabetes mellitus (DM) are prevalent in older adults.
- The combined impact of osteoporosis and CDs on healthcare expenditure is not fully understood.
Purpose of the Study:
- To evaluate the economic impact of osteoporosis on healthcare costs among patients with one or more chronic diseases.
- To compare healthcare costs between patients with chronic diseases only versus those with chronic diseases and osteoporosis (incident or prevalent).
Main Methods:
- Retrospective analysis of over 494,000 commercially insured or Medicare Advantage members aged 50+.
- Cohorts were defined by the presence/absence of osteoporosis and specific chronic diseases (CDs).
- Total healthcare costs over a 1-year follow-up were analyzed using a generalized linear model.
Main Results:
- Patients with chronic diseases plus incident osteoporosis incurred substantially higher costs compared to those with chronic diseases alone.
- Costs for CD plus incident osteoporosis ranged from $15,696 (CVD) to $23,860 (multiple CDs).
- CD plus prevalent osteoporosis also showed increased costs, ranging from $10,038 (CVD) to $17,997 (multiple CDs).
Conclusions:
- Osteoporosis significantly elevates healthcare costs for patients managing chronic diseases.
- The economic burden is particularly pronounced for individuals with newly diagnosed (incident) osteoporosis.
- These findings underscore the importance of managing osteoporosis in patients with chronic conditions to mitigate healthcare spending.
Objective:
To assess the impact of osteoporosis on health care costs for patients with chronic disease (CD): cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), depression, diabetes mellitus (DM), or two or more of these CDs.
Methods:
This retrospective analysis included commercially insured or Medicare Advantage male and female members aged 50 years or older with medical and pharmacy benefits who had evidence of osteoporosis and/or one of the CDs during the identification period (January 1, 2007, to October 31, 2009). Cohorts were defined by the presence or absence of osteoporosis and CD (osteoporosis ONLY, CD ONLY, and CD plus osteoporosis) and, for osteoporosis cohorts, by incident (recent diagnosis) or prevalent osteoporosis (long-standing). Primary outcome was total health care costs during 1-year follow-up. Costs, adjusted for baseline characteristics, were analyzed with a generalized linear model with log link and gamma distribution.
Results:
Of the 494,160 patients, the majority had evidence of CD with or without osteoporosis: CVD (54%), two or more CDs (24%), DM (8%), depression (4%), COPD (1%); 9% had osteoporosis ONLY. The range of actual mean costs was as follows: CD ONLY, $8,377 (CVD) to $12,801 (two or more CDs); CD plus incident osteoporosis, $15,696 (CVD) to $23,860 (two or more CDs); CD plus prevalent osteoporosis, $10,038 (CVD) to $17,997 (two or more CDs). Compared with CD ONLY, baseline-adjusted costs were 66% (two or more CDs) to 91% (DM) higher for CD plus incident osteoporosis and 13% (CVD) to 23% (depression) higher for CD plus prevalent osteoporosis (P < 0.001).
Conclusions:
The burden of osteoporosis in patients with CD is significant, particularly for patients with newly diagnosed osteoporosis.
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