Korean J Clin Pharm.  2021 Mar;31(1):27-34. 10.24304/kjcp.2021.31.1.27.

Treatment Patterns of Osteoporosis and Factors Affecting the Prescribing of Bone-forming Agents: From a National Health Insurance Claims Database

• Jeong J
• Shin JY

• KMID: 2517301
• DOI: http://doi.org/10.24304/kjcp.2021.31.1.27

Abstract

Objective
To analyze osteoporosis treatment patterns and teriparatide prescription-associated factors in Korea by using a national health insurance claims database.
Methods
We utilized the Health Insurance Review & Assessment Service National Patients Sample claims database to identify patients (aged ≥50 years) with at least one osteoporosis claim (International Classification of Disease 10th revision code: M80, M81, M82) and at least one prescription for osteoporosis medication (antiresorptive agents: bisphosphonates, selective estrogen receptor modulators, denosumab, and calcitonin; bone-forming agent: teriparatide) in 2018. Demographic characteristics and healthcare utilization patterns were analyzed. Factors associated with teriparatide prescriptions were assessed using a multivariate logistic regression model.
Results
Records showed that 44,815 patients were prescribed osteoporosis medications in 2018; the percentage of patients prescribed each treatment was as follows: 86.6% bisphosphonates, 13.9% selective estrogen receptor modulators, 3.1% calcitonin, 2.1% denosumab, and 0.7% teriparatide. A greater proportion of patients prescribed teriparatide were ≥75 years (53.4% vs. 33.8%) and had fractures (63.9% vs. 12.8%) compared to the same for antiresorptives (p<0.001). Patients prescribed teriparatide had higher Charlson comorbidity index values (1.2±1.3 vs. 0.9±1.2) and were more frequently hospitalized (0.8±1.3 vs. 0.1±0.5) than those prescribed antiresorptives (p<0.001). Elderly patients (≥75 years old; adjusted OR=1.66; 95% CI 1.16-2.38) and those with fractures (adjusted OR=6.23; 95% CI 4.76-8.14) were more likely to be prescribed teriparatide than antiresorptives.
Conclusion
Patients prescribed teriparatide were older and more likely to have severe osteoporosis than those prescribed antiresorptives.

Keyword

Osteoporosis; treatment pattern; claims database; teriparatide; bone-forming agents