Budget impact analysis of osteoporosis medications for primary prevention of fractures in Taiwan
Taiwan's national health insurance currently only covers the use of osteoporosis drugs for the secondary prevention of fractures and does not provide coverage for primary prevention. The purpose of this study is to develop a model for analyzing the budgetary impact of the use of osteoporosis medications of primary prevention.
The budget impact model in this study is the “actual medication cost” minus the “medical expenses for all types of fractures that can be avoided by taking osteoporosis medications.” We developed six possible insurance payment plans for primary prevention based on the age of the patients and T-scores and performed eleven steps to estimate the budget impact of each payment plan.
The results of this study indicated that there may be 71,220 (T-score ≤ − 3.0, 75 + y/o) to 157,515 (T-score ≤ − 2.5, 65 + y/o) people using the drugs, and the budget impact may be US$26.28–58.98 million in 2019. However, the payment plans may avoid 492–766 fracture events and save medical expenditures for fracture treatment by US$1.30–2.02 million. The average costs for primary prevention within a year will be US$53,386–77,006.
The budget impact of using osteoporosis medications to primary prevention of fractures is significant, but it can be compensated due to savings in fracture treatment costs.
KeywordsBudget impact analysis Osteoporosis medication Primary prevention Taiwan
Budget impact analysis
International Society for Pharmacoeconomics and Outcomes Research Health Sciences Policy Council
Fracture Risk Assessment Tool
International Osteoporosis Foundation
World Health Organization
National Health Insurance
International Classification of Diseases, 9th edition
National Health Insurance Research Database
Dual-energy X-ray absorptiometry
KLW, CHW, YFC, and JCH conceptualized and designed the study. KLW, CHW, and YTL collected data and conducted the analyses. JCH and YTL drafted the manuscript. All authors reviewed all data, revised the manuscript critically for intellectual content, and approved the final version for submission.
This work was supported by National Cheng Kung University Hospital-the Show Chwan Health Care System R&D Project grant (Grant number: NCKUSCMH10710), National Cheng Kung University Hospital (Grant numbers: NCKUH-106-9007, NCKUH-10709012), and Taiwan Ministry of Science and Technology (Grant number: 106-2314-B-006-064-MY2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors have no competing interests.
Ethics approval and consent to participate
Use of the publicly published data and NHIRD for research purpose is exempt from IRB review in Taiwan.
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