Status quo of osteoporosis treatment in Japan disclosed by the National Database of Health Insurance Claims and Specific Health Checkups: too late in treatment initiation and too few in treated patients?

Abstract

Summary

For the first time ever, the details of osteoporotic treatment were unveiled through the big data published by the government of Japan. The number of patients being treated is low and treatment start is late, especially in men. Our data are useful for education to not only patients but also doctors.

Purpose

To analyze the current status and trend of osteoporosis treatment in Japan by analyzing the data on main drugs for osteoporosis disclosed in the National Database open data.

Methods

We used the National Database open data released by the Ministry of Health, Labour and Welfare in September 2018. Data on bisphosphonates, denosumab, and teriparatide were extracted to calculate the number of patients treated with these drugs based on the number of prescriptions filed. Using these prescription numbers, the proportion of patients treated with bisphosphonates, denosumab, or teriparatide among osteoporosis patients was calculated. Further, the data on the incidence of hip fractures were employed to validate the appropriateness of the timing of treatment initiation to osteoporosis patients in Japan.

Results

The number of patients in men administered bisphosphonates, denosumab, or teriparatide was about one tenth of that in women. The proportion of osteoporosis patients in men treated with bisphosphonates, denosumab, or teriparatide was highest in age group over 80 years at 19.4%. The proportion of osteoporosis patients in women treated with bisphosphonates, denosumab, or teriparatide was highest in age group 70–79 years at 23.7%. The incidence of hip fractures increases sharply over 80 years of age in both genders.

Conclusion

Our findings suggested that osteoporosis treatment should be initiated in younger age, especially in men, in order to avoid osteoporotic fractures in Japan.

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References

  1. 1.

    National Database of Health Insurance Claims and Specific Health Checkups of Japan.2019 Available at: “https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000177221_00002.html”. Accessed 11 May

  2. 2.

    Kamata Y, Minota S (2018) Wide difference in biologics usage and expenditure for the treatment of patients with rheumatoid arthritis in each prefecture in Japan analyzed using “National Database of Health Insurance Claims and Specific Health Checkups of Japan”. Rheumatol Int 38:663–668

    Article  Google Scholar 

  3. 3.

    Qaseem A, Forciea MA, McLean RM, Denberg TD (2017) Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians. Ann Intern Med 166:818–839

    Article  Google Scholar 

  4. 4.

    Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628

    Article  Google Scholar 

  5. 5.

    Population data that the Bureau of Statistics, the Ministry of Internal Affairs and Communications. Available at: http://www.stat.go.jp/data/jinsui/2016np/index.html. Accessed 11 May 2019

  6. 6.

    Orimo H, Yaegashi Y, Onoda T, Fukushima Y, Hosoi T, Sakata K (2009) Hip fracture incidence in Japan: estimates of new patients in 2007 and 20-year trends. Arch Osteoporos 4:71–77

    Article  Google Scholar 

  7. 7.

    Tamaki J, Fujimori K, Ikehara S, et al. (2019) Estimates of hip fracture incidence in Japan using the National Health Insurance Claim Database in 2012–2015. Osteoporos Int 30:975–983

  8. 8.

    Liberman UA, Weiss SR, Bröll J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs RW Jr, Dequeker J, Favus M, Seeman E, Recker RR, Capizzi T, Santora AC, Lombardi A, Shah RV, Hirsch LJ, Karpf DB (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 333:1437–1443

    CAS  Article  Google Scholar 

  9. 9.

    Hochberg MC, Thompson DE, Black DM, Quandt SA, Cauley J, Geusens P, Ross PD, Baran D (2005) Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. J Bone Miner Res 20:971–976

    CAS  Article  Google Scholar 

  10. 10.

    Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, Cummings SR, FLEX Research Group (2006) Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 296:2927–2938

    CAS  Article  Google Scholar 

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Correspondence to Yasuyuki Kamata.

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Kamata, Y., Minota, S. Status quo of osteoporosis treatment in Japan disclosed by the National Database of Health Insurance Claims and Specific Health Checkups: too late in treatment initiation and too few in treated patients?. Arch Osteoporos 14, 84 (2019). https://doi.org/10.1007/s11657-019-0637-7

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Keywords

  • Bisphosphonate
  • Denosumab
  • Teriparatide
  • National Database open data
  • Osteoporosis
  • Universal healthcare system