and Medicine for Seniors
Reducing hip fractures in U.S.
senior citizens would cost $2 billion
Study predicts 357,656 lifetime hip
fractures after wrist fracture in all U.S. females age 65 and older
By Senior Journal
4, 2018 – Most U.S. senior citizens over age 80 suffer with the steady
loss of bone due to osteoporosis, contributing to an estimated 2 million
bone fractures each year. A new study finds that routine bisphosphonate
drug treatment of women over 65 who sustain a distal radius (wrist)
fracture - one of the most common fractures associated with osteoporosis
- could significantly reduce the risk for additional fractures,
primarily hip fractures, but at an estimated cost of more than $2
The lifetime cost of a hip fracture
is estimated at $81,300, of which approximately 44 percent of the costs
are associated with nursing facility expenses. Hip fractures cause an
estimated 300,000 unplanned hospital admissions in the U.S. each year,
according to this new study presented this week at the 2015 Annual
Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
Bisphosphonates, a drug known to
increase bone mass and prevent fractures, has been associated with
atypical femur fractures in a small, but significant number of patients.
Researchers reviewed existing
literature and Medicare data to determine distal radius fracture
incidence and age-specific hip fracture rates after distal radius
fracture with and without bisphosphonate treatment. A model was then
created to determine future fracture rates with and without treatment,
and related costs.
The model predicted 357,656
lifetime hip fractures following distal radius fracture in all females
age 65 and older in the U.S. If these patients received regular
bisphosphonate treatment following a distal radius fracture, the number
of hip fractures would drop to 262,767 over the lifetime of these
patients; however, an estimated 19,464 patients would suffer an atypical
femur fracture as a result of the treatment.
The cost of routine bisphosphonate
treatment, including the cost for treating associated atypical femur
fractures, comes to a lifetime total of $19.5 billion, or approximately
$205,534 per avoided hip fracture.
"Our study suggests that routine
universal utilization of bisphosphonates in elderly women after distal
radius fracture would not be economically advantageous despite the cost
savings associated with reduction of the hip fracture burden in that
population," said lead study author, Suneel B. Bhat, MD, an orthopaedic
surgery resident at the Rothman Institute in Philadelphia, Pa.
The study authors also hypothesize
that the cost of bisphosphonates would need to drop to $70 per patient
each year, from the current average annual wholesale cost of $1,485 per
patient, to make the treatment affordable to every patient age 65 and
older following a wrist fracture. In addition, selecting patients at
lower risk for atypical femur fractures for treatment may reduce the
number of bisphosphonate-related fractures. Confirming patient
osteoporosis and fracture risk through a DEXA Scan (dual X-ray
Absorptiometry) before prescribing bisphosphonates remains the most
cost-effective method for treating osteoporosis and avoiding subsequent
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