PURPOSE: Current treatment options for osteoporosis have demonstrated increased bone mineral density with a decrease in associated fractures. To achieve these benefits, patients need to be adherent and persistent with their osteoporosis therapy. The study objective was to evaluate adherence and persistence associated with the use of commonly prescribed oral osteoporosis prescription therapies: alendronate, risedronate, and raloxifene.
METHODS: The study population was derived from a large geographically diverse managed care organization utilizing medical and pharmacy administration claims. Continuously enrolled, benefit-eligible females >45 years, newly diagnosed and treated for osteoporosis were identified between 7/1/2000 ¨C 12/31/2002. Drug utilization was evaluated over a 12-month follow-up period. Adherence was assessed using a medication possession ratio calculated as total days of therapy / number of days during follow-up. Persistence was defined as continuous therapy on the same drug with °Ü 45 day therapy gap.
RESULTS: The cohort (n=10,566) had a mean age of 64.4 ± 10.4 years. The initial agent distribution was: alendronate 6,881 (65%), risedronate 2,224 (21%), and raloxifene 1,461 (14%). 82% of alendronate patients and 70% of risedronate patients received weekly dosing. For the three products combined, more than half the patients had a 12-month adherence rate of less than 75%. 12-month adherence rates for each product were as follows: alendronate 61%; risedronate 58%; and raloxifene 54%. The percent of patients persistent during the 12-month follow up was: alendronate 21.3%, risedronate 19.4% and raloxifene 16.2%. For patients who discontinued therapy, the average number of months to discontinuation was comparable: alendronate 2.53, risedronate 2.53, and raloxifene 2.45.
CONCLUSION: Currently used chronic oral osteoporosis prescription therapies are associated with poor adherence and persistence, especially early after treatment initiation. Osteoporosis therapies that may lead to improved drug adherence and persistence are more likely to achieve the clinical benefits observed in clinical trials.
Disclosure Information:
Faculty Member's Name: MA Omar
I have no relationships to disclose.
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