Introduction: Based on the 2019 European scorecard, the estimated number of osteoporotic individuals in Greece is 683,679, but real-world data on prescriptions for osteoporosis and other concomitant diseases are lacking.
Purpose: The purpose of this study was to evaluate the prevalence and the effect of concomitant diseases in treatment patterns and annual cost of anti-osteoporotic treatment based on nation-wide real-world data.
Methods: The electronic prescription database of the National Organization for Health Care Services Provision (IDIKA) was used to capture individuals who received anti-osteoporotic treatment in 2019. IDIKA includes almost 100% of all prescriptions issued in Greece.
Results: A total of 288,983 subjects, corresponding to the 3.3% of the total adult Greek population (8,641,341 people) and to the 42.3% of the estimated osteoporotic individuals, had filled at least one anti-osteoporotic prescription during 2019. Oral bisphosphonates were more frequently prescribed (58.8%), followed by denosumab (39.4%). About 80% of the study population had at least one concomitant disease. Dyslipidemia and hypertension were the most frequently found diseases accounting for 64% and 54.8% of the study population, respectively. Dyslipidemia was more frequently diagnosed in females, while diabetes mellitus type 1 (DMT1) and 2, hypertension, and coronary artery disease (CAD) were more frequently encountered in males. The presence of at least one concomitant disease increased the prescription of oral bisphosphonates (OR: 1.08; 95%CI: 1.06-1.1) except for chronic kidney disease (CKD), in which denosumab was more frequently prescribed (OR: 1.6; 95%CI: 1.5-1.7). The annual cost of treatment per-patient was on average €323.33, and increased significantly with comorbidities with the greater increases being recorded for patients with CKD, DMT1, and CAD.
Conclusion: Eight out of 10 patients under osteoporosis treatment have at least one concomitant disease which increases the likelihood of oral bisphosphonates use and alters significantly the average annual cost of anti-osteoporotic pharmaceutical treatment.