Eleven years secular trend of the initiation of anti-osteoporosis medications and subsequent fractures in Taiwan: From 2008 to 2018

Tsung-Han Yang; Chen-Yu Wang; Shau-Huai Fu; Ding-Cheng Chan; Ho-Min Chen; Jou-Wei Lin; Chun-Feng Huang; Jen-Jia Yang; Chih-Hsing Wu; Jawl-Shan Hwang; Rong-Sen Yang

Journal of the Formosan Medical Association (Jan 2023)

Eleven years secular trend of the initiation of anti-osteoporosis medications and subsequent fractures in Taiwan: From 2008 to 2018

Tsung-Han Yang,
Chen-Yu Wang,
Shau-Huai Fu,
Ding-Cheng Chan,
Ho-Min Chen,
Jou-Wei Lin,
Chun-Feng Huang,
Jen-Jia Yang,
Chih-Hsing Wu,
Jawl-Shan Hwang,
Rong-Sen Yang

Affiliations

Tsung-Han Yang: Department of Orthopedics, NTU BioMedical Park Hospital, NTUH Hsin-Chu Branch, Hsin-Chu, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
Chen-Yu Wang: School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital Yun-Lin Branch, Douliu, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan
Shau-Huai Fu: Department of Orthopedics, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan
Ding-Cheng Chan: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Ho-Min Chen: Health Data Research Center, National Taiwan University, Taipei, Taiwan
Jou-Wei Lin: Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Douliu, Yunlin County, Taiwan
Chun-Feng Huang: Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
Jen-Jia Yang: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, Po Jen General Hospital, Taipei, Taiwan
Chih-Hsing Wu: Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Jawl-Shan Hwang: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang GungUniversit, Taoyuan, Taiwan; Corresponding author. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan.
Rong-Sen Yang: Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Orthopaedics, College of Medicine, National Taiwan University, No. 7, Chung-Shan S. Road, Taipei, Taiwan.

Journal volume & issue: Vol. 122
pp. S36 – S44

Abstract

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Background: Osteoporosis is a common metabolic bone disease that benefits from many newly developed anti-osteoporosis medications (AOMs). Reimbursement policies need to allocate medical budgets properly based on evidence-based data. This study aimed to investigate the 11-year secular trend, focusing on older age and males in this adjustment wave of the National Health Insurance reimbursement. Methods: We adopted a nationwide cohort from Taiwan's National Health Insurance Research Database (NHIRD). Patients undergoing newly initiated AOMs from 2008 to 2018 were included. The AOMs in this study included denosumab, zoledronate, ibandronate, alendronate, raloxifene, and risedronate. Patients <50 years, pathological fractures, missing data, and two AOMs prescribed were excluded. The real-world trends related to subsequent fragility fracture and death within 1 and 3 years were used to evaluate the potential effects due to revision of reimbursement policies. Results: Of 393,092 patients, among them, 336,229 patients met the criteria, whose mean age ranged from 73.3 to 74.4 years, and nearly 80% were female. Further analysis showed a steady increase of AOMs from 5567 (17.1%) and 8802 (27.0%) in 2008–6697 (18.3%) and 10,793 (29.5%) in 2018 for males and 80+ years respectively. The subsequent fragility fracture within one and three years post AOMs initiation was 5.81% and 11.80% in 2018. Conclusion: This study showed an immediate drop in AOMs prescription after the implementation of a new stricter reimbursement policy. It took 5 years to return the annual prescription number.

Published in Journal of the Formosan Medical Association

ISSN: 0929-6646 (Print)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: http://www.journals.elsevier.com/journal-of-the-formosan-medical-association/

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