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American Journal of Health-System Pharmacy, Vol. 66, Issue 13, 1191-1201
Copyright © 2009. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00

Clinical Report

Trends and determinants of prescription medication use for treatment of osteoporosis

 Joel F. Farley and Susan J. Blalock

JOEL F. FARLEY, PH.D., is Assistant Professor; and SUSAN J. BLALOCK, PH.D., is Associate Professor, Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina, Chapel Hill.

Address correspondence to Dr. Farley at the School of Pharmacy, University of North Carolina, 2201 Kerr Hall, Campus Box 7360, Chapel Hill, NC 27599 (jffarley{at}unc.edu).


Purpose. Trends in the use of different treatments for osteoporosis among the civilian, ambulatory U.S. population are described.

Methods. Data from the Medical Expenditure Panel Survey (MEPS) were used to estimate osteoporosis prevalence and treatment rates among individuals ages 50 years and older who self-reported having osteoporosis. Specific pharmacologic treatments analyzed included oral and transdermal estrogen and estrogen and progesterone combination products in women, injectable and transdermal testosterone products in men, oral bisphosphonate medications, raloxifene, and nasal calcitonin. Predisposing characteristics included sex, age, education, income, and race. Required characteristics included the use of an oral corticosteroid medication, having a fracture in the current MEPS year, presently smoking, and self-report of fair or poor health status.

Results. Self-report of osteoporosis increased steadily from approximately 3.2 million patients in 1999 to 7.2 million patients in 2005. This was associated with an increase of the number of patients who used medication for the treatment of osteoporosis from 2.3 million in 1999 to 5.6 million in 2005. Although medication use increased over time, only 77% of people with osteoporosis reported using medication for the treatment of osteoporosis in the previous year. Only 25.4% of men, 55.6% of blacks, 64.2% of patients without a usual source of health care, and 66.8% of patients who reported their health as fair or poor used medication for the treatment of osteoporosis in the previous year.

Conclusion. Although the MEPS data are based on patient self-report, the results from our study suggest that approximately one in four patients with osteoporosis did not receive prescription management for this condition.

Index terms: Androgens; Bisphosphonates; Calcitonin; Epidemiology; Estrogen agonist antagonists; Estrogens; Osteoporosis; Parathyroid hormones; Progestins; Raloxifene; Steroids, cortico-; Testosterone; Toxicity

 

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