Anti-Osteoporosis Therapy Not Adequately or Cost-Effectively Utilized

Researchers claim that older adults are not receiving adequate anti-osteoporosis therapy despite increased spending for anti-osteoporosis drugs (Arch Osteoporos. 2016;11[1]:28).

Fractures resulting from untreated osteoporosis are a potentially avoidable burden on health care resources. To investigate this issue, researchers studied the utilization and cost of anti-osteoporotic therapy using the 2013 Medicare Part D data.

Smita Jha, MD, and Timothy Bhattacharyya, MD, (National Institutes of Health, MD) found that Medicare and its beneficiaries spent ~$990 million on anti-osteoporotic therapy in 2013, but, despite this cost, only one in two adults (aged 65 and older with osteoporosis) received an anti-osteoporosis drug. 

Of the money spent, $756 million (77%) was attributable to brand name drugs which accounted for 2,459,931 claims (22%). Generic dispensing rate varied from 57% to 86% (mean 77 ± 6) across the different states in the United States. States that mandate substitution with generic equivalents had a higher generic dispensing rate compared to states that permit generic substitution (92% vs 90%; P < .05).

After adjusting for claim counts, they found that, if the states that permit substitution with generic equivalents showed the same generic dispensing rate of 9% as the states that mandate such substitution, there is a potential for savings of $7.5 million—approximately 9% of the total expenditure in these states on oral bisphosphonates alone. 

Researchers say these findings show a need for ongoing training for physicians who care for osteoporotic older adults, so they are able to manage the disease in a cost-effective manner, ensuring that patients are able to receive adequate therapy. —Amanda Del Signore