Utilization and expenditure on medicines for the management of osteoporosis in Ireland: A repeated cross-sectional study.

Aim: Osteoporosis is a prevalent skeletal disease characterized by low bone mass and increased fracture risk. Management of osteoporosis typically involves antiresorptive and anabolic therapies, which are reimbursed in Ireland through various drug schemes. This study aims to summarize the utilization patterns associated with medicines used in the management of osteoporosis in Ireland.

Methods: This study is a repeated cross-sectional analysis of the overall utilization of and expenditure on medicines used in the management of osteoporosis in Ireland. A number of additional drug utilization metrics are investigated: the rate of osteoporosis medication prescribing per 1000 General Medical Services eligible population, adherence to bisphosphonates, denosumab and teriparatide, and the proportion of patients initiating denosumab as first-line treatment.

Results: There has been a significant change in the utilization of medicines used for the treatment of osteoporosis in Ireland over the last 13 years. The associated total annual expenditure was €28.7 million in 2011, increasing to €33.8 million in 2023. The most commonly used medicines have changed significantly over the period analysed; in 2011 the majority of patients were treated with bisphosphonates, whereas from 2019, the majority of patients were treated with denosumab. Poor patterns of treatment adherence were observed in this study.

Conclusion: The findings suggest evolving patterns in osteoporosis management in the Irish context. The study highlights the need for ongoing monitoring of medication use to ensure safe, effective and cost-effective care in the context of an aging population at increasing risk for osteoporosis.