Secondary prevention of osteoporosis in Australia: Analysis of government-dispensed prescription data

Hollingworth, Samantha, Gunanti, Inong, Nissen, Lisa, & Duncan, Emma L. (2010) Secondary prevention of osteoporosis in Australia: Analysis of government-dispensed prescription data. Drugs and Aging, 27(3), pp. 255-264.

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Abstract

Background

Osteoporosis is a common cause of disability and death in elderly men and women. Until 2007, Australian Government-subsidized use of oral bisphosphonates, raloxifene and calcitriol (1α,25-dihydroxycholecalciferol) was limited to secondary prevention (requiring x-ray evidence of previous low-trauma fracture). The cost to the Pharmaceutical Benefits Scheme was substantial (164 million Australian dollars in 2005/6).

Objective

To examine the dispensed prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products for the secondary prevention of osteoporosis (after previous low-trauma fracture) in the Australian population.

Methods

We analysed government data on prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products from 1995 to 2006, and by sex and age from 2002 to 2006. Prescription counts were converted to defined daily doses (DDD)/1000 population/day. This standardized drug utilization method used census population data, and adjusts for the effects of aging in the Australian population.

Results

Total bisphosphonate use increased 460% from 2.19 to 12.26 DDD/1000 population/day between June 2000 and June 2006. The proportion of total bisphosphonate use in June 2006 was 75.1% alendronate, 24.6% risedronate and 0.3% etidronate. Raloxifene use in June 2006 was 1.32 DDD/1000 population/day. The weekly forms of alendronate and risedronate, introduced in 2001 and 2003, respectively, were quickly adopted. Bisphosphonate use peaked at age 80–89 years in females and 85–94 years in males, with 3-fold higher use in females than in males.

Conclusions

Pharmaceutical intervention for osteoporosis in Australia is increasing with most use in the elderly, the population at greatest risk of fracture. However, fracture prevalence in this population is considerably higher than prescribing of effective anti-osteoporosis medications, representing a missed opportunity for the quality use of medicines.

Impact and interest:

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8 citations in Web of Science®

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ID Code: 77315
Item Type: Journal Article
Refereed: Yes
Keywords: Bisphosphonates, therapeutic use; Calcitriol, therapeutic use; Calcium, therapeutic use; Drug-utilisation; Elderly; Osteoporosis, prevention; Prescribing; Raloxifene, therapeutic use.
DOI: 10.2165/11318400-000000000-00000
ISSN: 1170-229X
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2010 Springer
Deposited On: 07 Oct 2014 07:05
Last Modified: 24 Mar 2016 01:08

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