Skip to main content
main-content
Erschienen in: Archives of Osteoporosis 1/2022

01.12.2022 | Original Article

Impact of osteoporosis liaison services on the expected lifetime osteoporosis-related medical expenses of patients with fragility fracture in a private hospital in Japan

verfasst von: Saori Kobayashi, Shinya Tanaka, Yasumasa Yoshino, Hideki Tobita, Kanae Kuwagaki, Rie Fujioka, Hiroaki Totsuka, Yuka Ichiba, Sachiko Ishimine, Kazumi Sakamoto, Hikaru Ohama, Toshiro Kubo

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

Abstract

Summary

We report the efficacy of a Japanese fracture liaison service (FLS), the osteoporosis liaison service (OLS), in suppressing osteoporosis-related expenses from the public insurance by preventing secondary fracture in spite of higher medication costs during expected life spans. OLS could reduce medical expenses for osteoporosis in all age groups.

Purpose

Osteoporosis liaison services (OLS), which are based on fracture liaison services (FLS), are used in Japan to prevent both primary and secondary fractures in older people. We aimed to clarify the effects of OLS on the medical expenses.

Patients and methods

We compared patients with fragile fractures hospitalized to Saitama Jikei Hospital before and after implementing OLS. These were labeled a non-OLS group and an OLS group, and they were further organized by age (< 75, 75–84, and ≥ 85 years). The expected osteoporosis-related medical expenses during life were calculated by the occurrence, fracture site, medication, and life expectancy and compared between the non-OLS and OLS groups by the age group.

Results

The non-OLS group included 400 people (100 males and 300 females, mean age 81.7 ± 9.7 years), comprising 154 with vertebral fractures and 246 with hip fractures. The OLS group included 406 patients (101 males and 305 females, mean age 82.4 ± 9.3 years), of whom 161 had vertebral fractures and 245 had hip fractures. The suppressive secondary fracture effects of OLS were previously reported. The expected expense of osteoporosis treatment in the OLS group was found to be greater than that in the non-OLS group for all age groups. In contrast, expected expenses for treating secondary fractures were shown to increase more in the non-OLS group. However, total expenses were lower in the OLS group across all age groups.

Conclusion

The implementation of OLS can reduce overall healthcare costs despite the increased expenses required to provide medical therapy and periodic examinations.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14(12):1028–1034 CrossRefPubMed McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14(12):1028–1034 CrossRefPubMed
2.
Zurück zum Zitat Garofoli R, Maravic M, Ostertag A, Cohen-Solal M (2019) Secular trends of hip fractures in France: impact of changing characteristics of the background population. Osteoporos Int 30(2):355–362 CrossRefPubMed Garofoli R, Maravic M, Ostertag A, Cohen-Solal M (2019) Secular trends of hip fractures in France: impact of changing characteristics of the background population. Osteoporos Int 30(2):355–362 CrossRefPubMed
3.
Zurück zum Zitat Yong EL, Ganesan G, Kramer MS, Howe TS, Koh JSB, Thu WP, Logan S, Cauley JA, Tan KB. (2020) Risk factors and trends associated with mortality among adults with hip fracture in Singapore. JAMA Netw Open 3(2):e1919706 Yong EL, Ganesan G, Kramer MS, Howe TS, Koh JSB, Thu WP, Logan S, Cauley JA, Tan KB. (2020) Risk factors and trends associated with mortality among adults with hip fracture in Singapore. JAMA Netw Open 3(2):e1919706
4.
Zurück zum Zitat Chen FP, Shyu YC, Fu TS, Sun CC, Chao AS, Tsai TL, Huang TS (2017) Secular trends in incidence and recurrence rates of hip fracture: a nationwide population-based study. Osteoporos Int 28(3):811–818 CrossRefPubMed Chen FP, Shyu YC, Fu TS, Sun CC, Chao AS, Tsai TL, Huang TS (2017) Secular trends in incidence and recurrence rates of hip fracture: a nationwide population-based study. Osteoporos Int 28(3):811–818 CrossRefPubMed
5.
Zurück zum Zitat Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA; IOF CSA Working Group on Fracture Epidemiology (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288 CrossRef Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA; IOF CSA Working Group on Fracture Epidemiology (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288 CrossRef
6.
Zurück zum Zitat Pennestrì F, Corbetta S, Favero V, Banfi G (2019) Fragility fracture prevention-implementing a fracture liaison service in a high-volume orthopedic hospital. Int J Environ Res Public Health 16(24):4902 CrossRefPubMedCentral Pennestrì F, Corbetta S, Favero V, Banfi G (2019) Fragility fracture prevention-implementing a fracture liaison service in a high-volume orthopedic hospital. Int J Environ Res Public Health 16(24):4902 CrossRefPubMedCentral
7.
Zurück zum Zitat Bachour F, Rizkallah M, Sebaaly A, Barakat A, Razzouk H, El Hage R, Nasr R, El Khoury M, Maalouf G (2017) Fracture liaison service: report on the first successful experience from the Middle East. Arch Osteoporos 12(1):79 CrossRefPubMed Bachour F, Rizkallah M, Sebaaly A, Barakat A, Razzouk H, El Hage R, Nasr R, El Khoury M, Maalouf G (2017) Fracture liaison service: report on the first successful experience from the Middle East. Arch Osteoporos 12(1):79 CrossRefPubMed
8.
Zurück zum Zitat Axelsson KF, Jacobsson R, Lund D, Lorentzon M (2016) Effectiveness of a minimal resource fracture liaison service. Osteoporos Int 27(11):3165–3175 CrossRefPubMedPubMedCentral Axelsson KF, Jacobsson R, Lund D, Lorentzon M (2016) Effectiveness of a minimal resource fracture liaison service. Osteoporos Int 27(11):3165–3175 CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Nakayama A, Major G, Holliday E, Attia J, Bogduk N (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27(3):873–879 CrossRefPubMed Nakayama A, Major G, Holliday E, Attia J, Bogduk N (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27(3):873–879 CrossRefPubMed
10.
Zurück zum Zitat Huntjens KM, van Geel TA, van den Bergh JP, van Helden S, Willems P, Winkens B, Eisman JA, Geusens PP, Brink PR. (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96(4):e29 Huntjens KM, van Geel TA, van den Bergh JP, van Helden S, Willems P, Winkens B, Eisman JA, Geusens PP, Brink PR. (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96(4):e29
11.
Zurück zum Zitat van Geel TACM, Bliuc D, Geusens PPM, Center JR, Dinant GJ, Tran T, van den Bergh JPW, McLellan AR, Eisman JA. (2018) Reduced mortality and subsequent fracture risk associated with oral bisphosphonate recommendation in a fracture liaison service setting: A prospective cohort study. PLOS ONE 13(6):e0198006 van Geel TACM, Bliuc D, Geusens PPM, Center JR, Dinant GJ, Tran T, van den Bergh JPW, McLellan AR, Eisman JA. (2018) Reduced mortality and subsequent fracture risk associated with oral bisphosphonate recommendation in a fracture liaison service setting: A prospective cohort study. PLOS ONE 13(6):e0198006
12.
Zurück zum Zitat Singh S, Whitehurst DG, Funnell L, Scott V, MacDonald V, Leung PM, Friesen K, Feldman F (2019) Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia. Canada Arch Osteoporos 14(1):116 CrossRefPubMed Singh S, Whitehurst DG, Funnell L, Scott V, MacDonald V, Leung PM, Friesen K, Feldman F (2019) Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia. Canada Arch Osteoporos 14(1):116 CrossRefPubMed
13.
Zurück zum Zitat Vrignaud A, Pelletier S, Dernis E, Moui Y, Haettich B (2018) Improvement in the primary and secondary prevention of osteoporosis by a Fracture Liaison Service: feedback from a single French center care pathway. Arch Osteoporos 13(1):110 CrossRefPubMed Vrignaud A, Pelletier S, Dernis E, Moui Y, Haettich B (2018) Improvement in the primary and secondary prevention of osteoporosis by a Fracture Liaison Service: feedback from a single French center care pathway. Arch Osteoporos 13(1):110 CrossRefPubMed
14.
Zurück zum Zitat Takusari E, Sakata K, Hashimoto T, Fukushima Y, Nakamura T, Orimo H. (2021) Trends in hip fracture incidence in Japan: estimates based on nationwide hip fracture surveys from 1992 to 2017. JBMR Plus 5(2):e10428 Takusari E, Sakata K, Hashimoto T, Fukushima Y, Nakamura T, Orimo H. (2021) Trends in hip fracture incidence in Japan: estimates based on nationwide hip fracture surveys from 1992 to 2017. JBMR Plus 5(2):e10428
15.
Zurück zum Zitat Tamaki J, Fujimori K, Ikehara S, Kamiya K, Nakatoh S, Okimoto N, Ogawa S, Ishii S, Iki M, Working Group of Japan Osteoporosis Foundation (2019) Estimates of hip fracture incidence in Japan using the National Health Insurance Claim Database in 2012–2015. Osteoporos Int 30(5):975–983 CrossRef Tamaki J, Fujimori K, Ikehara S, Kamiya K, Nakatoh S, Okimoto N, Ogawa S, Ishii S, Iki M, Working Group of Japan Osteoporosis Foundation (2019) Estimates of hip fracture incidence in Japan using the National Health Insurance Claim Database in 2012–2015. Osteoporos Int 30(5):975–983 CrossRef
16.
Zurück zum Zitat The population of Kumagaya city, Kumagaya city government office The population of Kumagaya city, Kumagaya city government office
18.
Zurück zum Zitat Yoshino Y, Tanaka S, Ohama H, Kobayashi S, Tobita H, Kuwagaki K, Fujioka R, Totsuka H, Ichiba Y, Ishimine S, Sakamoto K, Kubo T (2021) Effectiveness of a Japanese multi-professional cooperative osteoporosis liaison service at a private hospital for decreasing secondary fractures in osteoporosis patients with fragility fractures. Arch Osteoporos 16(1):75 CrossRefPubMed Yoshino Y, Tanaka S, Ohama H, Kobayashi S, Tobita H, Kuwagaki K, Fujioka R, Totsuka H, Ichiba Y, Ishimine S, Sakamoto K, Kubo T (2021) Effectiveness of a Japanese multi-professional cooperative osteoporosis liaison service at a private hospital for decreasing secondary fractures in osteoporosis patients with fragility fractures. Arch Osteoporos 16(1):75 CrossRefPubMed
19.
Zurück zum Zitat Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, Cooper C, Javaid MK, Judge A, and the REFReSH Study Group (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: A population-based study. J Bone Miner Res 32(2):203–211 CrossRef Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, Cooper C, Javaid MK, Judge A, and the REFReSH Study Group (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: A population-based study. J Bone Miner Res 32(2):203–211 CrossRef
20.
Zurück zum Zitat Moriwaki K, Noto S (2017) Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. Osteoporos Int 28(2):621–632 CrossRefPubMed Moriwaki K, Noto S (2017) Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. Osteoporos Int 28(2):621–632 CrossRefPubMed
21.
Zurück zum Zitat Yong JH, Masucci L, Hoch JS, Sujic R, Beaton D (2016) Cost-effectiveness of a fracture liaison service–a real-world evaluation after 6 years of service provision. Osteoporos Int 27(1):231–240 CrossRefPubMed Yong JH, Masucci L, Hoch JS, Sujic R, Beaton D (2016) Cost-effectiveness of a fracture liaison service–a real-world evaluation after 6 years of service provision. Osteoporos Int 27(1):231–240 CrossRefPubMed
22.
Zurück zum Zitat 2019 Life tables. Director-General for Statistics and Information Policy, Ministry of Health, Labor and Welfare Japan 2019 Life tables. Director-General for Statistics and Information Policy, Ministry of Health, Labor and Welfare Japan
24.
Zurück zum Zitat Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521 CrossRefPubMed Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521 CrossRefPubMed
25.
Zurück zum Zitat Hagino H, Tanaka K, Silverman S, McClung M, Gandra SR, Charokopou M, Adachi K, Johnson B, Stollenwerk B (2021) Cost effectiveness of romosozumab versus teriparatide for severe postmenopausal osteoporosis in Japan. Osteoporos Int 32(10):2011–2021 CrossRefPubMed Hagino H, Tanaka K, Silverman S, McClung M, Gandra SR, Charokopou M, Adachi K, Johnson B, Stollenwerk B (2021) Cost effectiveness of romosozumab versus teriparatide for severe postmenopausal osteoporosis in Japan. Osteoporos Int 32(10):2011–2021 CrossRefPubMed
26.
Zurück zum Zitat Shiroiwa T, Fukuda T, Ikeda S, Takura T, Moriwaki K (2017) Development of an official guideline for the economic evaluation of drugs/medical devices in Japan. Value Health 20(3):372–378 CrossRefPubMed Shiroiwa T, Fukuda T, Ikeda S, Takura T, Moriwaki K (2017) Development of an official guideline for the economic evaluation of drugs/medical devices in Japan. Value Health 20(3):372–378 CrossRefPubMed
27.
Zurück zum Zitat Leal J, Gray AM, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK, Judge A, REFReSH study group. (2016) Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int 27(2):549–558 CrossRefPubMed Leal J, Gray AM, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK, Judge A, REFReSH study group. (2016) Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int 27(2):549–558 CrossRefPubMed
28.
Zurück zum Zitat Pike C, Birnbaum HG, Schiller M, Sharma H, Burge R, Edgell ET (2010) Direct and indirect costs of non-vertebral fracture patients with osteoporosis in the US. Pharmacoeconomics 28(5):395–409 CrossRefPubMed Pike C, Birnbaum HG, Schiller M, Sharma H, Burge R, Edgell ET (2010) Direct and indirect costs of non-vertebral fracture patients with osteoporosis in the US. Pharmacoeconomics 28(5):395–409 CrossRefPubMed
29.
Zurück zum Zitat Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90(1):14–21 CrossRefPubMed Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90(1):14–21 CrossRefPubMed
30.
Zurück zum Zitat Senay A, Fernandes JC, Delisle J, Morin SN, Perreault S (2019) Persistence and compliance to osteoporosis therapy in a fracture liaison service: a prospective cohort study. Arch Osteoporos 14(1):87 CrossRefPubMed Senay A, Fernandes JC, Delisle J, Morin SN, Perreault S (2019) Persistence and compliance to osteoporosis therapy in a fracture liaison service: a prospective cohort study. Arch Osteoporos 14(1):87 CrossRefPubMed
31.
Zurück zum Zitat van Geel TACM, Bliuc D, Geusens PPM, Center JR, Dinant GJ, Tran T, van den Bergh JPW, McLellan AR, Eisman JA. (2018) Reduced mortality and subsequent fracture risk associated with oral bisphosphonate recommendation in a fracture liaison service setting: A prospective cohort study. PLOS ONE 13(6):e0198006 van Geel TACM, Bliuc D, Geusens PPM, Center JR, Dinant GJ, Tran T, van den Bergh JPW, McLellan AR, Eisman JA. (2018) Reduced mortality and subsequent fracture risk associated with oral bisphosphonate recommendation in a fracture liaison service setting: A prospective cohort study. PLOS ONE 13(6):e0198006
32.
Zurück zum Zitat Barton DW, Piple AS, Smith CT, Moskal SA, Carmouche JJ (2021) The clinical impact of fracture liaison services: A systematic review. Geriatr Orthop Surg Rehabil 12:2151459320979978 CrossRefPubMedPubMedCentral Barton DW, Piple AS, Smith CT, Moskal SA, Carmouche JJ (2021) The clinical impact of fracture liaison services: A systematic review. Geriatr Orthop Surg Rehabil 12:2151459320979978 CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Soong YK, Tsai KS, Huang HY, Yang RS, Chen JF, Wu PC, Huang KE (2013) Risk of refracture associated with compliance and persistence with bisphosphonate therapy in Taiwan. Osteoporos Int 24(2):511–521 CrossRefPubMed Soong YK, Tsai KS, Huang HY, Yang RS, Chen JF, Wu PC, Huang KE (2013) Risk of refracture associated with compliance and persistence with bisphosphonate therapy in Taiwan. Osteoporos Int 24(2):511–521 CrossRefPubMed
34.
Zurück zum Zitat Blouin J, Dragomir A, Moride Y, Ste-Marie LG, Fernandes JC, Perreault S (2008) Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol 66(1):117–127 CrossRefPubMedPubMedCentral Blouin J, Dragomir A, Moride Y, Ste-Marie LG, Fernandes JC, Perreault S (2008) Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol 66(1):117–127 CrossRefPubMedPubMedCentral
Metadaten
Titel
Impact of osteoporosis liaison services on the expected lifetime osteoporosis-related medical expenses of patients with fragility fracture in a private hospital in Japan
verfasst von
Saori Kobayashi
Shinya Tanaka
Yasumasa Yoshino
Hideki Tobita
Kanae Kuwagaki
Rie Fujioka
Hiroaki Totsuka
Yuka Ichiba
Sachiko Ishimine
Kazumi Sakamoto
Hikaru Ohama
Toshiro Kubo
Publikationsdatum
01.12.2022
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2022
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01101-0

Weitere Artikel der Ausgabe 1/2022

Archives of Osteoporosis 1/2022 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, DICOM-Daten, Videos und Abbildungen. » Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.