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Economic burden of osteoporosis-related hip fracture in Asia: a systematic review

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Abstract

Summary

This review analyzes the economic costs of HF in Asia. The availability and quality of studies on the burden of osteoporosis in Asia are very scarce. There is a need to encourage more quality cost of osteoporosis studies based on standardized methods to convince healthcare authorities in implementing appropriate strategies.

Introduction

Osteoporosis fractures, especially hip fractures, impose large economic costs to governments and societies. This review aimed to systematically analyze available evidence on healthcare costs associated with osteoporosis-related hip fractures (HF) in Asia.

Methods

Articles were systematically sought from databases including PubMed, EMBASE, and EBSCOHost between 2000 and 2015. Total costs associated with HF care, the cost components, and length of stays were retrieved and analyzed. Study designs were also qualitatively analyzed.

Results

The availability of published studies on economic burden of HF in Asia is severely lacking with only 15 articles met the inclusion criteria. Even among the included studies, only two studies reported comprehensive costs evaluating all costs including indirect or intangible costs. Most studies satisfactorily reported criteria for conducting economic evaluation, but large variations existed in the methodological design. Due to study design and other influencing factors, large variation in the cost of HF treatment from US$774 to US$14,198.90 (median S$2943), representing an average of 18.95% (range: 3.58–57.05%) of the countries’ 2014 GDP/capita, was observed. This highlighted the heavy burden of managing HF in Asia with about 40% of the included studies reported using more than one third of GDP/capita.

Conclusion

There is a paucity of burden of illness studies of osteoporosis in the Asian region. For the few available studies, there was a lack of standardization in methodological approach in evaluating the economic burden of the disease. There is a need to encourage more quality burden of illness studies of osteoporosis to inform policymakers in healthcare planning.

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References

  1. Mithal A, Kaur P (2012) Osteoporosis in Asia: a call to action. Current Osteoporosis Reports 10(4):245–247. doi:10.1007/s11914-012-0114-3

    Article  PubMed  Google Scholar 

  2. Mithal A, Ebeling P, Kyer C (2013) The Asia-Pacific regional audit: epidemiology, costs, and burden of osteoporosis in 2013. International Osteoporosis Foundation

  3. World Health Organization (2003) The burden of musculoskeletal conditions at the start of the new millennium: report of a WHO scientific group. World Health Organization, Geneva

    Google Scholar 

  4. Dhanwal DK, Dennison EM, Harvey NC, Cooper C (2011) Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop 45(1):15–22

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mithal A, Dhingra V (2009) Epidemiology, costs and burden of osteoporosis in Asia 2009. The Asian Audit International Osteoporosis Foundation

  6. Budhia S, Mikyas Y, Tang M, Badamgarav E (2012) Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. PharmacoEconomics 30(2):147–170. doi:10.2165/11596880-000000000-00000

    Article  PubMed  Google Scholar 

  7. Drummond MF (2005) Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press

  8. Ben Sedrine W, Radican L, Reginster JY (2001) On conducting burden-of-osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO collaborating center. Rheumatol (Oxf) 40(1):7–14

    Article  CAS  Google Scholar 

  9. The World Bank, World Development Indicators (2014) GDP per capita. Retrieved from http://databank.worldbank.org/data/. [database on the Internet]. Accessed: 13/10/2016

  10. National Statistics Republic of China (Taiwan). Principal Figures 2014. Retrieved from http://eng.stat.gov.tw/ct.asp?xItem=37408&CtNode=5347&mp=5. [database on the Internet]. Accessed: 13/10/2016

  11. Gao L, Hu H, Zhao F-L, Li S-C (2016) Can the direct medical cost of chronic disease be transferred across different countries? Using cost-of-illness studies on type 2 diabetes, epilepsy and schizophrenia as examples. PLoS One 11(1). doi:10.1371/journal.pone.0147169

  12. Zhao FL, Xie F, Hu H, Li SC (2013) Transferability of indirect cost of chronic disease: a systematic review and meta-analysis. PharmacoEconomics 31(6):501–508. doi:10.1007/s40273-013-0053-6

    Article  PubMed  Google Scholar 

  13. Chan DC, Lee YS, Wu YJ, Tsou HH, Chen CT, Hwang JS et al (2013) A 12-year ecological study of hip fracture rates among older Taiwanese adults. Calcif Tissue Int 93(5):397–404

    Article  PubMed  CAS  Google Scholar 

  14. Moriwaki K, Komaba H, Noto S, Yanagisawa S, Takiguchi T, Inoue H et al (2013) Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan. J Bone Miner Res 28(2):395–403

    Article  PubMed  Google Scholar 

  15. Nagata-Kobayashi S, Shimbo T, Fukui T (2002) Cost-effectiveness analysis of screening for osteoporosis in postmenopausal Japanese women. J Bone Miner Metab (Eng ed) 20(6):350–357. doi:10.1007/s007740200051

    Article  Google Scholar 

  16. Borgstrom F, Johnell O, Kanis JA, Jonsson B, Rehnberg C (2006) At what hip fracture risk is it cost-effective to treat? International intervention thresholds for the treatment of osteoporosis. Osteoporos Int 17(10):1459–1471. doi:10.1007/s00198-006-0107-0

    Article  PubMed  CAS  Google Scholar 

  17. Ho WW, Kwan Dai DL, Liu KW, Chow KM, Lau E, Woo J et al (2009) To investigate the effect and cost-effectiveness of implementing an orthogeriatric intervention for elderly patients with acute hip fracture: the experience in Hong Kong. J Am Geriatr Soc 57(11):2153–2154. doi:10.1111/j.1532-5415.2009.02529.x

    Article  PubMed  Google Scholar 

  18. Shabat S, Heller E, Mann G, Gepstein R, Fredman B, Nyska M (2003) Economic consequences of operative delay for hip fractures in a non-profit institution. Orthopedics (Thorofare NJ) 26(12):1197–1199 discussion 9

    Google Scholar 

  19. Karn NK, Singh GK, Kumar P, Shrestha B, Singh MP, Gowda MJ (2006) Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal. J Bone Jt Surg Br Vol 88(10):1347–1350. doi:10.1302/0301-620x.88b10.18023

    Article  CAS  Google Scholar 

  20. Borgstrom F, Lekander I, Ivergard M, Strom O, Svedbom A, Alekna V et al (2013) The international costs and utilities related to osteoporotic fractures study (ICUROS) - quality of life during the first 4 months after fracture. Osteoporos Int 24(3):811–823

    Article  PubMed  CAS  Google Scholar 

  21. Sadat-Ali M, Al-Dakheel DA, Azam MQ, Al-Bluwi MT, Al-Farhan MF, AlAmer HA et al. (2015) Reassessment of osteoporosis-related femoral fractures and economic burden in Saudi Arabia. Arch Osteoporos. 10 (1) (no pagination)(37)

  22. Si L, Winzenberg TM, Jiang Q, Chen M, Palmer AJ (2015) Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int 26(7):1929–1937

    Article  PubMed  CAS  Google Scholar 

  23. Segal E, Zinnman C, Raz B, Tamir A, Gurevich B, Siebzehner MI et al (2005) Second hip fracture in elderly hip fracture patients: cost and effectiveness of fracture prevention treatment. Age Ageing 34(5):507–510

    Article  PubMed  CAS  Google Scholar 

  24. Xie Z, Burge R, Yang Y, Du F, Lu T, Huang Q et al. (2015) Posthospital discharge medical care costs and family burden associated with osteoporotic fracture patients in China from 2011 to 2013. J Osteoporos. 2015 (no pagination)(258089)

  25. Qu B, Ma Y, Yan M, Wu HH, Fan L, Liao DF et al (2014) The economic burden of fracture patients with osteoporosis in western China. Osteoporos Int 25(7):1853–1860. doi:10.1007/s00198-014-2699-0

    Article  PubMed  CAS  Google Scholar 

  26. Saeb M, Beyranvand M, Basiri Z, Haghparast-Bidgoli H (2014) The hospital resource utilization associated with osteoporotic hip fractures in Kermanshah. Iran J Inj Violence Res 6(1):16–20

    PubMed  Google Scholar 

  27. Kang HY, Park SE, Kang DR, Kim JY, Jang YH, Choi WJ et al (2009) Estimating medical expenditure associated with osteoporotic hip fracture in elderly Korean women based on the national health insurance claims database 2002-2004. Value Health 12(SUPPL. 3):S93–SS6

    Article  PubMed  Google Scholar 

  28. Tanriover MD, Oz SG, Tanriover A, Kilicarslan A, Turkmen E, Guven GS et al (2010) Hip fractures in a developing country: osteoporosis frequency, predisposing factors and treatment costs. Arch Gerontol Geriatr 50(3):e13–ee8

    Article  PubMed  Google Scholar 

  29. Lee YH, Lim YW, Lam KS (2008) Economic cost of osteoporotic hip fractures in Singapore. Singap Med J 49(12):980–984

    CAS  Google Scholar 

  30. Dai K, Zhang Q, Fan T, Sen SS (2007) Estimation of resource utilization associated with osteoporotic hip fracture and level of post-acute care in China. Curr Med Res Opin 23(12):2937–2943

    Article  PubMed  Google Scholar 

  31. Chen LT, Lee JA, Chua BS, Howe TS (2007) Hip fractures in the elderly: the impact of comorbid illnesses on hospitalisation costs. Ann Acad Med Singap 36(9):784–787

    PubMed  Google Scholar 

  32. Woratanarat P, Wajanavisit W, Lertbusayanukul C, Loahacharoensombat W, Ongphiphatanakul B (2005) Cost analysis of osteoporotic hip fractures. Chot Mai Het Thang Phaet 88(Suppl 5):S96–104

    PubMed  Google Scholar 

  33. Ishizaki T, Imanaka Y, Oh E, Kuwabara K, Hirose M, Hayashida K et al (2004) Association of hospital resource use with comorbidity status and patient age among hip fracture patients in Japan. Health Policy (Amst Print) 69(2):179–187. doi:10.1016/j.healthpol.2003.12.018

    Article  Google Scholar 

  34. Hepguler S, Cetin A, Deger C, Erkent U (2011) Osteoporotic hip fracture costs in the elderly Turkish population. Acta Orthop Traumatol Turc 45(5):316–325

    PubMed  Google Scholar 

  35. Bubshait D, Sadat-Ali M (2007) Economic implications of osteoporosis-related femoral fractures in Saudi Arabian society. Calcif Tissue Int 81(6):455–458

    Article  PubMed  CAS  Google Scholar 

  36. Yang Y, Du F, Ye W, Chen Y, Li J, Zhang J et al (2015) Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis. ClinicoEcon Outcomes Res 7:205–212

    PubMed  PubMed Central  Google Scholar 

  37. Dhar D (2006) The economic impact of treating geriatric hip fracture–a study at Rustag referral hospital, south batinah region. Oman Age and Ageing 3(3):17–19

    Google Scholar 

  38. Chang CY, Tang CH, Chen KC, Huang KC (2016) The mortality and direct medical costs of osteoporotic fractures among postmenopausal women in Taiwan. Osteoporos Int 27(2):665–676

    Article  PubMed  Google Scholar 

  39. Kim J, Lee E, Kim S, Lee TJ (2016) Economic burden of osteoporotic fracture of the elderly in South Korea: a National Survey. Value in Health Regional Issues 9:36–41

    Article  PubMed  Google Scholar 

  40. Liu GG, Eggleston K, Hu T-W (2008) Emerging health economics and outcomes research in the Asia-Pacific region. Value Health 11(Supplement 1(0)):S1–S2. doi:10.1111/j.1524-4733.2008.00360.x

    Article  PubMed  Google Scholar 

  41. Valzania C, Torbica A, Tarricone R, Leyva F, Boriani G (2016) Implant rates of cardiac implantable electrical devices in Europe: a systematic literature review. Health Policy (Amst Print) 120(1):1–15. doi:10.1016/j.healthpol.2015.11.001

    Article  Google Scholar 

  42. Drummond M, Barbieri M, Cook J, Glick HA, Lis J, Malik F et al (2009) Transferability of economic evaluations across jurisdictions: ISPOR good research practices task force report. Value Health 12(4):409–418. doi:10.1111/j.1524-4733.2008.00489.x

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Discipline of Pharmacy and Experimental Pharmacology, School of Biomedical Sciences and Pharmacy, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    N-A. Mohd-Tahir & S-C. Li

  2. Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

    N-A. Mohd-Tahir

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  1. N-A. Mohd-Tahir
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  2. S-C. Li
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Correspondence to S-C. Li.

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The views expressed in the submitted article are the authors own opinion’s and does not express the views of their official position of the institution or funder.

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Mohd-Tahir, NA., Li, SC. Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int 28, 2035–2044 (2017). https://doi.org/10.1007/s00198-017-3985-4

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