Skip to main content
SpringerLink
Log in
Book cover

Vertebral Compression Fractures in Osteoporotic and Pathologic Bone pp 21–29Cite as

The Economic Burden of Osteoporosis

  • Chapter
  • First Online:

Abstract

Osteoporosis is the most common metabolic bone disorder; through its prevalence and utilization of healthcare resources, the disease creates an enormous medical and economic burden that is set to worsen based on current population predictions. The transition of US healthcare from a volume-based to value-based reimbursement system presents an opportunity to address large population health problems such as osteoporosis. By reorganizing treatment plans and outcomes around the needs of the patient, the burden of osteoporosis can be managed in a more cost-effective way.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477–81.

    Article  CAS  PubMed  Google Scholar 

  2. Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harv Bus Rev. 2011;89:46–52.

    PubMed  Google Scholar 

  3. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, WHO technical report series 843. Geneva: WHO; 1994.

    Google Scholar 

  4. Buist DS, LaCroix AZ, Manfredonia D, Abbott T. Identifying postmenopausal women at high risk of fracture in populations: a comparison of three strategies. J Am Geriatr Soc. 2002;50:1031–8.

    Article  PubMed  Google Scholar 

  5. National Osteoporosis Foundation. Prevalence report [online]. Available from URL: http://www.nof.org/advocacy/resources/prevalencereport. Accessed 17 Sept 2017.

  6. Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randal S, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014;29(11):2520–6.

    Article  PubMed  Google Scholar 

  7. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2006;4(22):465–75.

    Google Scholar 

  8. Day JC. Population projections of the United States by age, sex, race, and hispanic origin: 1995 to 2050. Washington, D.C.: U.S. Government Printing Office; 1996.

    Google Scholar 

  9. World Health Organization Technical Report: Assessment of Osteoporosis at the Primary Health Care Level [online]. Available from URL: https://www.sheffield.ac.uk/FRAX/pdfs. Accessed 17 Sept 2017.

  10. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–33.

    Article  CAS  PubMed  Google Scholar 

  11. Melton LJ 3rd, Atkinson EJ, O’Connor MK, O’Fallon WM, Riggs BL. Bone density and fracture risk in men. J Bone Miner Res. 1998;13(12):1915–23.

    Article  PubMed  Google Scholar 

  12. Melton LJ 3rd, Chrischilles EA, Cooper C, Lane AW, Riggs BL. Perspective. How many women have osteoporosis? J Bone Miner Res. 1992;7(9):1005–10.

    Article  PubMed  Google Scholar 

  13. Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int. 2000;11(8):669–74.

    Article  CAS  PubMed  Google Scholar 

  14. Kim DH, Vaccaro AR. Osteoporotic compression fractures of the spine: current options and considerations for treatment. Spine J. 2006;6(5):479–87.

    Article  PubMed  Google Scholar 

  15. Compston J. Osteoporosis: social and economic impact. Radiol Clin N Am. 2010;48(3):477–82.

    Article  PubMed  Google Scholar 

  16. Ismail AA, Cockerill W, Cooper C, Finn JD, Abendroth K, Parisi G, et al. Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int. 2001;12(2):85–90.

    Article  CAS  PubMed  Google Scholar 

  17. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285:320–3.

    Article  CAS  PubMed  Google Scholar 

  18. Hirano T, Hasegawa K, Takahashi HE, Uchiyama S, Hara T, Washio T, et al. Structural characteristics of the pedicle and its role in screw stability. Spine. 1997;22(21):2504–9.

    Article  CAS  PubMed  Google Scholar 

  19. Richardson ML, Genant HK, Cann CE, Ettinger B, Gordan GS, Kolb FO, et al. Assessment of metabolic bone diseases by quantitative computed tomography. Clin Orthop Relat Res. 1985;(195):224–38.

    Google Scholar 

  20. Wu ZX, Gong FT, Liu L, Ma ZS, Zhang Y, Zhao X, et al. A comparative study on screw loosening in osteoporotic lumbar spine fusion between expandable and conventional pedicle screws. Arch Orthop Trauma Surg. 2012;132(4):471–6.

    Article  PubMed  Google Scholar 

  21. Truummees E, Demetropoulos CK, Yang KH, Herkowitz HN. Failure of human cervical endplates: a cadaveric experimental model. Spine. 2003;28(19):2204–8.

    Article  Google Scholar 

  22. Hasegawa K, Abe M, Washio T, Hara T. An experimental study of the interface strength between titanium mesh cage and vertebra in reference to vertebral bone mineral density. Spine. 2001;26(8):957–63.

    Article  CAS  PubMed  Google Scholar 

  23. Jost B, Cripton PA, Lund T, Oxland TR, Lippuner K, Jaeger P, et al. Compressive strength of interbody cages in the lumbar spine: the effect of cage shape, posterior instrumentation, and bone density. Eur Spine J. 1998;7(2):132–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Levy P, Levy E, Audran M, Cohen-Solal M, Faredllone P, Le Parc JM. The cost of osteoporosis in men: the French situation. Bone. 2002;30(4):631–6.

    Article  CAS  PubMed  Google Scholar 

  25. Sasser AC, Rousculp MD, Birnbaum HG, Oster EF, Lufkin E, Mallet D. Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population. Womens Health Issues. 2005;15(3):97–108.

    Article  PubMed  Google Scholar 

  26. Vanness DJ, Tosteson AN. Estimating the opportunity costs of osteoporosis in the United States. Top Geriatr Rehabil. 2005;21:4–16.

    Article  Google Scholar 

  27. Ray NF, Chan JK, Thamer M, Melton LJ 3rd. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997;12(1):24–35.

    Article  CAS  PubMed  Google Scholar 

  28. Hoerger TJ, Downs KE, Lakshmanan MC, Lindrooth RC, Plouffe L Jr, Wendling B, et al. Healthcare use among U.S. women aged 45 and older: Total costs and costs for selected postmenopausal health risks. J Womens Health Gend Based Med. 1999;8(8):1077–89.

    Article  CAS  PubMed  Google Scholar 

  29. Chrischilles E, Shireman T, Wallace R. Costs and health effects of osteoporotic fractures. Bone. 1994;15(4):377–86.

    Article  CAS  PubMed  Google Scholar 

  30. Phillips S, Fox N, Jacobs J, Wright WE. The direct medical costs of osteoporosis for American women aged 45 and older, 1986. Bone. 1988;9(5):271–9.

    Article  CAS  PubMed  Google Scholar 

  31. Holbrook TL, Grazier K, Kelsey JL, Stauffer RN. Frequency of occurrence, impact and cost of selected musculoskeletal conditions in the United States. Chicago: American Academy of Orthopedic Surgeons; 1998.

    Google Scholar 

  32. Truumees E. Osteoporosis. Spine. 2001;26:930–2.

    Article  CAS  PubMed  Google Scholar 

  33. Melton LJ 3rd, Gabriel SE, Crowson CS, Tosteson AN, Johnell O, Kanis JA. Cost-equivalence of different osteoporotic fractures. Osteoporos Int. 2003;14(5):383–8.

    Article  PubMed  Google Scholar 

  34. Gabriel SE, Tosteson ANA, Leibson CL, Crowson CS, Pond GR, Hammond CS, Melton LJ 3rd. Direct medical costs attributable to osteoporotic fractures. Osteoporos Int. 2002;13(4):323–30.

    Article  CAS  PubMed  Google Scholar 

  35. Viswanathan HN, Curtis JR, Yu J, White J, Stolshek BS, Merinar C, et al. Direct healthcare costs of osteoporosis-related fractures in managed care patients receiving pharmacological osteoporosis therapy. Appl Health Econ Health Policy. 2012;10(3):163–73.

    Article  PubMed  Google Scholar 

  36. Orsini LS, Rousculp MD, Long SR, Wang S. Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures. Osteoporos Int. 2005;16(4):359–71.

    Article  PubMed  Google Scholar 

  37. Licata AA. Cost analysis of medical and surgical treatment of vertebral fractures. In: Szpalski M, Gunzburg R, editors. Vertebral osteoporotic compression fractures. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 257–60.

    Google Scholar 

  38. Zampini JM, White AP, McGuire KJ. Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty. Clin Orthop Relat Res. 2010;468(7):1773–80.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Gehlbach SH, Burge RT, Puleo E, Klar J. Hospital care of osteoporosis-related vertebral fractures. Osteoporos Int. 2003;14:53–60.

    Article  CAS  PubMed  Google Scholar 

  40. Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361(6):569–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361(6):557–68.

    Article  CAS  PubMed  Google Scholar 

  42. New guideline recommends against use of vertebroplasty [online]. Available from URL: https://www.aaos.org/AAOSNow/2010/Oct/cover/cover1/?ssopc=1. Accessed 17 Jan 2018.

  43. Lee HM, Park SY, Lee SH, Suh SW, Hong JY. Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fracture (OVCFs): conservative treatment versus balloon kyphoplasty. Spine J. 2012;12(11):998–1005.

    Article  PubMed  Google Scholar 

  44. Morris CA, Cabral D, Cheng H, Katz JN, Finkelstein JS, Avorn J, et al. Patterns of bone mineral density testing: current guidelines, testing rates, and interventions. J Gen Intern Med. 2004;19(7):783–90.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Amarnath AL, Franks P, Robbins JA, Xing G, Fenton JJ. Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study. J Gen Intern Med. 2015;30(12):1733–40.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Zhao JG, Zeng XT, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. JAMA. 2017;318(24):2466–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, et al. Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. J Clin Endocrinol Metab. 2000;85(11):4118–24.

    Article  CAS  PubMed  Google Scholar 

  48. Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. JAMA. 1999;282(14):1344–52.

    Article  CAS  PubMed  Google Scholar 

  49. Qaseem A, Forciea MA, McLean RM, Denberg TD, Clinical Guidelines Committee of the American College of Physicians. 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. 2017;166(11):818–39.

    Article  PubMed  Google Scholar 

  50. Nguyen TV, Center JR, Eisman JA. Osteoporosis: underrated, underdiagnosed and undertreated. Med J Aust. 2004;180(5 Suppl):S18–22.

    PubMed  Google Scholar 

  51. Nakayama A, Major G, Holliday E. Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int. 2016;27(3):873–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Harold A. Fogel

  2. Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA

    Louis G. Jenis

Authors
  1. Harold A. Fogel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louis G. Jenis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Harold A. Fogel .

Editor information

Editors and Affiliations

  1. Vice Chair and Residency Program Director, Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA

    Afshin E. Razi

  2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Stuart H. Hershman

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fogel, H.A., Jenis, L.G. (2020). The Economic Burden of Osteoporosis. In: Razi, A., Hershman, S. (eds) Vertebral Compression Fractures in Osteoporotic and Pathologic Bone. Springer, Cham. https://doi.org/10.1007/978-3-030-33861-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-33861-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33860-2

  • Online ISBN: 978-3-030-33861-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation