Introduction: Based on the 2019 European scorecard, osteoporosis is diagnosed in an estimated number of 683,679 individuals in Greece with the direct cost of incident fractures reaching €694,7 million, but relevant real-world data are scarce.
Methods: The e-Government Centre for Social Security Services prescription-database, which covers 99.9% of the Greek population, was used to capture all individuals on anti-osteoporotic treatment during 2019.
Results: A total of 288,983 among 8,641,341 people, corresponding to the 3.3% of the total adult Greek population, had filled at least one anti-osteoporotic prescription (6.0% and 0.36% for females and males, respectively). Prevalence of anti-osteoporotic treatment increased with age, from 0.15% in those younger than 50 to 8.6% in those older than 70 years. Oral-bisphosphonates were more frequently prescribed (58.8%), followed by denosumab (39.4%). Alendronate was more frequently prescribed in males and in people younger than 60 years. Denosumab was more frequently prescribed in females and in people older than 60 years. Selective estrogen-receptors modulators, teriparatide and parenteral-bisphosphonates accounted for 1.1%, 1.0% and 0.02% of all prescriptions, respectively. Orthopedic-surgeons (39.6 %), Endocrinologists (19.6%), General-Practitioners (19 %), and Rheumatologists (9.3%), prescribed the vast majority of anti-osteoporotic regimens, with significant differences in prescription patterns. The annual cost of treatment per-patient increased significantly with age, being on average €323.33.
Conclusions: About 42% of the estimated number of individuals with osteoporosis in 2019 in Greece received treatment with the total annual cost being about €93 million. The impact of this under-treatment on fracture incidence and related health-care costs deserves further investigation.