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Cost and management of males with closed fractures

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Abstract

Summary

The purpose of this study was to examine the medical costs and the management of osteoporosis in the 12 months after a closed fracture for men aged ≥ 45 years. The mean medical cost per fracture was high ($6,078–$30,900), and osteoporosis management post fracture was inadequate in the majority of men.

Introduction

This study was conducted in order to examine the medical costs following fracture in males and the management of osteoporosis post fracture.

Methods

Administrative claims from a large, national health plan were analyzed. Men ≥ 45 years were included if they had ≥ 1 medical claim for a new closed fracture between January 1, 2005 and December 31, 2008. Commercially insured (COM) and Medicare Advantage Plan (MAP) members were analyzed separately. Costs were calculated as paid amounts and adjusted to 2010 dollars. Both the differences between the individual patients’ 12-month pre-fracture and 12-month post-fracture costs and the costs directly attributed to the fracture were reported. The prevalence of dual-energy X-ray absorptiometry (DXA) scan and/or osteoporosis pharmacotherapy treatment was evaluated in the 12 months post fracture.

Results

We identified 18,917 (COM, 16,191; MAP, 2,726) men with new closed fractures. Non-hip, non-vertebral fractures (NHNV) were the most common fracture in both COM and MAP populations. Fracture costs ranged from $7,121 to $15,830 for vertebral fractures, from $22,601 to $30,900 for hip fractures, and from $6,078 to $8,344 for NHNV fractures. In the COM and MAP populations, respectively, 8.5 and 15.5 % had a DXA scan and/or osteoporosis pharmacotherapy in the 12 months following the fracture.

Conclusions

Healthcare costs associated with fractures in men are substantial. About 1 in 12 men ≥ 45 years in the COM population were provided adequate follow-up for osteoporosis post fracture. While this rate improved to about one in six men in the MAP population, osteoporosis management in men post fracture is far from optimal.

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Acknowledgments

This study was funded by Amgen Inc. The authors wish to thank Laura Christensen, MS for contributions to the study design, and Gretchen E. Parker, PhD, RAC (OptumInsight) and Yeshi Mikyas, PhD (Amgen Inc.) for assistance with the preparation of this manuscript.

Conflicts of interest

This study was funded by Amgen Inc. NY is an employee of and owns stock or stock options in Amgen Inc. SKB and YF are employees of OptumInsight, which received funding to conduct the study.

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Authors and Affiliations

  1. OptumInsight, 12525 Technology Drive, Eden Prairie, MN, 55344, USA

    S. K. Brenneman & Y. Fan

  2. Amgen, Inc, One Amgen Center Drive, Thousand Oaks, CA, 91320, USA

    N. Yurgin

Authors
  1. S. K. Brenneman
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  2. N. Yurgin
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  3. Y. Fan
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Correspondence to S. K. Brenneman.

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Brenneman, S.K., Yurgin, N. & Fan, Y. Cost and management of males with closed fractures. Osteoporos Int 24, 825–833 (2013). https://doi.org/10.1007/s00198-012-2067-x

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  • DOI: https://doi.org/10.1007/s00198-012-2067-x

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