Full Text: Resource Utilization in Postmenopausal Osteoporosis Without Incident Fractures

Resource Utilization in Postmenopausal Osteoporosis Without Incident Fractures

SÉRGIO CANDIDO KOWALSKI, VERA LÚCIA SJENZFELD, and MARCOS BOSI FERRAZ

ABSTRACT.

Objective. To evaluate the annual utilization and cost incurred by postmenopausal women with osteoporosis in a public tertiary healthcare facility.

Methods. One hundred consecutive patients with postmenopausal osteoporosis were selected from the Universidade Federal de São Paulo (UNIFESP), Brazil. The socioeconomic and clinical characteristics, quality of life, and resource utilization and costs in the last year were assessed using 3 questionnaires. Each resource used had its unitary cost based on the Public Healthcare System Table of Fees (1998).

Results. The mean age was 66 years and the monthly family income was US$ 456 (1998). There was a mean of 7 visits/patient/year. Seventy-seven percent of the patients used calcium and 38% used estrogens. There were no incident fractures during the study. The mean total annual cost for osteoporosis treatment, considering the societal perspective, was US$ 775 (1998) per patient/year.

Conclusion. The costs of all treatment drugs related and not related to osteoporosis represented 9% of the monthly household income. Among some drugs used, many are lacking evidence of effectiveness, such as shark cartilage. The costs related to transportation were significant, representing 21% of the total directly spent by the patients. Further studies are necessary to rationally drive treatment, based on the best cost-effectiveness strategies of osteoporosis management. (J Rheumatol 2004;31:938-42)

Key Indexing Terms:

COSTS
OSTEOPOROSIS
RESOURCE UTILIZATION

From the Department of Medicine-Division of Rheumatology and the Department of Medicine-Paulista Center for Health Economics, Universidade Federal de São Paulo, São Paulo, Brazil.

S.C. Kowalski, MSc, Graduate Student; V.L. Sjenzfeld, PhD, Associate Professor; M.B. Ferraz, PhD, Associate Professor, Department of Medicine-Division of Rheumatology and Coordinator, Paulista Center for Health Economics.

Address reprint requests to Dr. S. Kowalski, Universidade Federal de São Paulo, Department of Medicine, Division of Rheumatology, 740 Botucatu 3rd floor, São Paulo SP Brazil, 040 23 062. E-mail: sckowalski@uol.com.br

Submitted March 24, 2003; revision accepted November 7, 2003.