Economic implications of osteoporotic fractures in postmenopausal women

Osteoporosis is a condition affecting millions of Americans, the majority of which are women secondary to low estrogen in the postmenopausal state. In many instances, the diagnosis is not recognized until after a fracture has occurred due to the "silent" nature of this disease. As a result, this leads to millions of fractures each year, placing a substantial economic burden of billions of dollars from Medicare alone. Prevention, early diagnosis, and treatment remain paramount in reducing this economic impact as well as improving overall incidence of mortality and morbidity. Goals of care include preventing the progression of disease and minimizing bone fractures, particularly in the hips, spine, and wrists. This article will examine the risks of osteoporosis and osteoporotic fractures in postmenopausal women, the current and emerging pharmacologic treatment options, and the role of managed care pharmacists in decreasing economic burden and improving patient care.