A cost-saving analysis of pharmacologic management in osteoporotic fracture prevention among postmenopausal women.

UNLABELLED: Pharmacologic therapy reduces osteoporotic fractures and generates substantial cost savings. A meta-analysis of 30 RCTs showed bisphosphonates, HRT, and biologics lower fracture risk by 31%, 27%, and 40%, respectively. Cost analysis revealed net savings of up to $12.8 billion annually and up to $118 billion over the next 10 years.

PURPOSE: Osteoporotic fractures are a significant concern among postmenopausal women, leading to substantial healthcare costs. This study aims to evaluate the cost savings associated with pharmacologic management in preventing osteoporotic fractures among postmenopausal women.

METHODS

A systematic review and meta-analysis were conducted to evaluate pharmacologic interventions for osteoporotic fracture prevention in postmenopausal women and identified studies comparing HRT, bisphosphonates, and biologics to placebo. A random-effects model was used to pool data and assess fracture reduction. Cost analysis utilized Medicare data, including cost and expenditures. Net savings were calculated by subtracting drug costs from gross savings, with a 10-year projection estimating long-term economic impact.

RESULTS

A meta-analysis of 30 randomized controlled trials (86,411 patients) showed a significant reduction in fracture risk with pharmacologic therapy (RR = 0.70, p < 0.001). HRT reduced fracture risk by 27%, bisphosphonates by 31%, and biologics by 40%. Cost analysis showed annual net savings of $3.35B for bisphosphonates, $3.01B for HRT, and $1.33B for biologics at $8600 per fracture. Over 10 years, HRT could reduce cumulative costs by $118B.

CONCLUSIONS

Pharmacologic therapies, particularly bisphosphonates and hormone therapy, effectively reduce fracture incidence and generate substantial cost savings in high-risk postmenopausal women. Enhancing accessibility, affordability, and adherence through system-wide initiatives can mitigate osteoporosis's economic burden. Future research should optimize treatment strategies and assess emerging therapies for cost-effectiveness and long-term sustainability.