Healthcare and productivity cost of osteoporosis: a Danish register-based quasi-experimental study.

Osteoporosis significantly impacts healthcare costs in Denmark, with annual expenses exceeding €3097 per individual. The total annual burden of healthcare and productivity losses attributed to osteoporosis in Denmark surpasses €2 billion. Effective prevention, early detection, and management strategies should be considered to offset these costs and improve patient outcomes.

Purpose: As the prevalence of osteoporosis rises, driven by an ageing population, quantifying its financial impact and guiding resource allocation becomes crucial. The aim of this paper is to establish the healthcare (medical and social care) costs and productivity costs attributable to osteoporosis and osteoporosis-related fractures in Denmark.

Methods: The osteoporosis and osteoporosis fracture groups were identified from Danish healthcare registers using ICD-10 codes. The intervention group included individuals born in 1930-1950 with an osteoporosis diagnosis or an osteoporotic fracture with incidence between 2000 and 2021. A control group without osteoporosis and osteoporosis fractures was matched 1: 1 on a number of clinical and demographic variables from the general Danish population. Difference-in-difference approach was applied through generalised estimating equations with individual-level fixed effects to establish attributable costs.

Results: Osteoporosis and osteoporosis-related fractures can be attributed with more than €3097 annually in healthcare costs for individuals aged 50 to 91, with expenses increasing sharply with age. Cumulative attributable healthcare (medical and social care) cost of osteoporosis between the ages of 50 and 91 was estimated at reach €127,000 per person. For the identified population of over 667,000 people with osteoporosis, the total annual healthcare burden attributable to the disease would amount to over €2 billion. The osteoporosis group also incurred an annual productivity loss of €3883, until the age of 66.

Conclusion: Osteoporosis carries a pronounced economic burden for the health system and the individual. Resource allocative decisions should consider whether implementing strategies improving prevention, earlier detection, and better management of osteoporosis could be efficient given the high identified costs.