Global Problem Of Adherence To Osteoporosis Treatment Puts Lives At Risk And Costs Billions

A new report from the International Osteoporosis Foundation (IOF) details for the first time the global implications and significant personal, social and economic costs associated with women not staying on their osteoporosis treatment.



Approximately half of patients stop taking their weekly treatment within a year,1,2 leaving them open to a greater risk of broken bones and increasing the strain on financially-strapped healthcare systems. The report signals the launch of the IOF Staying Power: Closing the Adherence Gap in Osteoporosis campaign, which seeks to highlight the true burden of non-adherence.



Implications of not staying on treatment


Osteoporosis is a widespread disease affecting one woman in three and one man in five.3,4,5 It is treatable, yet lack of adherence to treatment is a huge problem in osteoporosis, with many patients finding it difficult to continue with medication for the recommended long-term period. This lack of adherence is important for people with osteoporosis, since fewer than one third of women who experience a fracture will regain their previous level of mobility and over a third will require constant care.6



It also has a significant financial impact since, in Europe alone, osteoporosis now costs more than ?4.8 billion a year in hospital healthcare7 - and unless the fracture rate is reduced these costs are likely to increase still further. In women over 45, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, heart attack and breast cancer.8



European trends extend worldwide with huge economic cost


The Staying Power dossier builds on a 2005 IOF report, The Adherence Gap: Why Osteoporosis Patients Don't Continue with Treatment, which identified lack of adherence in five large European countries. The new report shows that the European pattern of non-adherence extends throughout the world.



-- By 2050 the worldwide cost burden is forecasted to increase to a minimum of ?106 billion (US$131.5 billion)9


-- Over half of Brazilian physicians questioned in a new survey, included in the dossier, estimated the annual cost of treating osteoporosis-related fractures to be in excess of ?81 million (US$100 million)10


-- In the UK the annual cost of osteoporotic fractures is between ?2.2 - ?2.6 billion (?1.5 - ?1.8 billion)11


-- In Spain 25,000 fractures occur each year, resulting in direct costs of more than ?126 million and indirect costs of ?420 million12


-- During 2001-2003, an estimated 2.39 million osteoporosis fractures occurred in the USA, resulting in government health insurance costs of ?10 billion (US$13 billion)13















-- In Australia, musculoskeletal disorders amount to an estimated total expenditure of ?1.8 billion (AUS $3 billion)14



Staying Power campaign launched


International film star Britt Ekland, who has osteoporosis, joined IOF representatives today in Vienna to launch the Staying Power campaign. This multi-dimensional campaign calls for women, doctors and patient groups around the world to work together in their efforts to help women stay on their treatment long-term and lessen the risk of unnecessary, debilitating broken bones.



Ms Ekland, known for her role in films such as Get Carter and the James Bond film The Man With the Golden Gun commented: "I have had osteoporosis for ten years and I urge all women with osteoporosis to seek advice from their doctor and local patient groups in order to understand what treatments are available and how best to stay on therapy."



Staying on treatment is recognised as a major problem in the management of many chronic diseases, including osteoporosis. Ms Ekland continued: "I am aware of the profound impact osteoporosis can have on everyday activities and, whilst I have been fortunate enough to continue leading an active life, many women are not so lucky. Staying on treatment could mean avoiding a life of decreased mobility, chronic pain, deformity and low self-esteem."



The issue of adherence is important because once a bone breaks, patients are significantly more likely to break another.15,16 With an ageing global population, the number of people suffering from osteoporosis is likely to increase in coming years, making it even more important to help patients get the bone strengthening benefits their treatment can only provide over time.



Professor Jean-Yves Reginster, Professor of Epidemiology, Public Health and Health Economics at the University of Liege, Belgium and IOF General Secretary said: "The social and economic costs of women not staying on their treatment simply cannot be sustained. Doctors, women and patient groups must all work together now to combat this situation. Ensuring osteoporosis treatments are more 'patient-friendly' is crucial and there are new options available, including less frequent dosing, which can help."



Paul Spencer Sochaczewski, Head of Communications for IOF echoed these thoughts: "The adherence issue needs to be addressed as a matter of urgency. Through the Staying Power campaign, IOF calls for action from people with osteoporosis, physicians, patient groups and government healthcare systems to address the worrying findings published in the report issued today. As a starting point, IOF will bring together its member patient groups later this year to discuss adherence, identify workable solutions and implement them as quickly as possible. We urge anyone involved in the field of osteoporosis to give this issue similar focus."



Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases, death. One out of three women over 50 will experience osteoporotic fractures, as will one out of five men. 3,4,5



Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain extent, be prevented, it can be easily diagnosed and effective treatments are available.



The International Osteoporosis Foundation (IOF) is the only worldwide organization dedicated to the fight against osteoporosis. It brings together scientists, physicians, patient societies and corporate partners. Working with its 170 member societies in 84 locations, and other healthcare-related organizations around the world, IOF encourages awareness and prevention, early detection and improved treatment of osteoporosis.



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REFERENCES



1. Cramer J, Amonkar MM, Hebborn A and Suppapanya N. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal Bone Mineral Research 2004; 19 Suppl 1: S448


2. Ettinger MP, Gallagher R, Amonkar M, Smith JC, and MacCosbe PE. Medication persistence is improved with less frequent dosing of bisphosphonates, but remains inadequate. Arthritis Rheum. 2004; 50 Suppl 1: S513


3. Melton LJ, Chrischilles EA, Cooper C, Lane AW and Riggs BL. Perspective. How many women have osteoporosis? Journal Bone and Mineral Research 1992; 7 (9): 1005-10


4. Melton LJ, Atkinson EJ, O'Connor MK, O'Fallon WM and Riggs BL. Bone density and fracture risk in men. Journal of Bone Mineral Research 1998; 13 (12): 1915-23


5. Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis International 2000; 11 (8): 669-74


6. Milne HW; International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. Invest in your bones: make it or break it. How exercise helps to build and maintain strong bones, prevent falls and fractures, and speed rehabilitation. Osteoporosis Australia and International Osteoporosis Foundation. Sydney (Australia): 2005


7. Lips P; International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. Invest in your bones: quality of life. Why prevent the first fracture? International Osteoporosis Foundation (IOF). Nyon (Switzerland): 2003


8. Kanis JA, Delmas P, Burckhardt P, Cooper C and Torgerson D; The European Foundation for Osteoporosis and Bone Disease. Guidelines for diagnosis and management of osteoporosis. Osteoporosis International 1997; 7: 390-406


9. Johnell O. The socioeconomic burden of fractures: today and in the 21st century. American Journal of Medicine 1997; 103(2A): 20S-25S


10. TCA Pesquisa e Assessoria de Marketing Ltda. Osteoporosis Project. April 2005. Sponsored by Roche


11. National Institute for Health and Clinical Excellence (NICE). Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. Technology Appraisal 87. London (UK): 2005


12. Gimeno A, Gua?abens N, Monegal A and Peris P. Consulta de... osteoporosis. Prous Science. Barcelona (Spain): 2005


13. King AB, Saag KG, Burge RT, Pisu M and Goel N. Fracture reduction affects Medicare economics (FRAME): impact of increased osteoporosis diagnosis and treatment. Osteoporosis International 2005; 16: 1545-1557


14. Access Economics Pty Ltd. The Burden of brittle bones: costing osteoporosis in Australia. Canberra (Australia): 2001


15. Nevitt MC, Ross PD, Palermo L, Musliner T, Genant K and Thompson DE; Fracture intervention trial research group. Association of prevalent vertebral fractures, bone density, and alendronate treatment with incident vertebral fractures: Effect of number and spinal location of fractures. Bone 1999; 25 (5): 613-619


16. Johnell O, Oden A, Caulin F and Kanis JA. Acute and long-term increase in fracture risk after hospitalisation for vertebral fracture. Osteoporosis International 2001; 12: 207-214




The Staying Power report and related activities are supported by an unrestricted educational grant from Roche and GlaxoSmithKline (GSK).



There are many medically-proven treatments for osteoporosis. The International Osteoporosis Foundation (IOF) does not endorse or recommend any specific treatment. Such decisions must be made by the physician and patient.