(290) Economic burden of osteoporosis in the United States: A systematic literature review

Background: : In the United States (US), approximately 10.2 million people over 50 years of age are affected by osteoporosis. As the population ages, it is important to evaluate its economic impact on the healthcare system.

Objective: : The objective of this systematic literature review to summarize the latest available evidence on the economic burden of osteoporosis in the US.

Methods: : A systematic literature search was conducted on Embase and MEDLINE (via Embase.com) from January 2014 to September 2024. The bibliographical review of recent studies and relevant conference screening were also performed for additional relevant studies. Studies investigating the economic burden of osteoporosis in the US published in English language were included. Reviews, clinical trials, case series/reports, and economic modeling studies were excluded. Key details of the eligible studies, including study and patient characteristics (i.e. study design, follow-up, age, gender, and comorbidities) were extracted and summarized qualitatively. Cost outcomes, such as all-cause total healthcare costs and resource use were descriptively analyzed.

Results: : A total of 6,158 records were identified initially, of which 25 studies met the eligibility criteria and were included. All 25 studies reported direct costs and/or resource use. Additionally, one study reported indirect costs. Most of the included studies focused on patients with fractures. The annual average all-cause total healthcare costs for patients with osteoporotic fractures ranged from $19,386 to $47,163 and were significantly higher compared to patients without fractures. Inpatient costs were the primary contributor to higher all-cause healthcare costs in patients with fractures. Among different fracture types, hip fractures were linked to the highest costs (ranged from $35,536 to $86,427). Having subsequent fractures (vs. no subsequent fractures), being male (vs. female), older age, and a higher Charlson Comorbidity Index were also associated with higher all-cause total healthcare costs. Patients with fractures had significantly more days of workplace absenteeism and short-term disability than patients without fractures, with the related costs also being significantly higher for patients with fractures.

Conclusions: : The economic burden of osteoporosis is substantial, with associated costs rising significantly in the presence of fractures. Early identification and prevention strategies aimed at reducing the risk of fractures is an essential step to alleviate the impact on both patients and the healthcare system.

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