Prevalence and incidence of patients with an osteoporosis diagnosis and high fracture risk

Introduction:

This study was conducted to obtain epidemiological insights into the prevalence and incidence of osteoporosis as well as the number of osteoporosis patients that are at high risk of fracture(s) in Germany.

Methods:

The data for this analysis was provided by a German statutory sick fund, (AOK PLUS; 3.0 million insured persons in 2016, 24.07% female patients (≥55 years) and 14.49% male patients (≥60years)). We identified patients with at least one osteoporosis diagnosis (ICD-10 codes M80.*/M81.*) between 2010 and 2016. Among them, patients alive at 01/01/2016 with previous or incident fractures in 2016 were identified based on the respective ICD-10 codes. A high risk of fracture(s) was defined according to DVO guidelines as prevalent vertebral or femoral fracture (fx) or other constellations requiring an osteoporosis treatment or glucocorticoid induced osteoporosis (GIOP). Numbers of affected patients based on the sick fund data were extrapolated to the entire German population, based on their age and gender structure.

Results:

The age- and gender-adjusted prevalence of osteoporosis diagnosis in the AOK PLUS population in 2016 was 177,802 patients; extrapolated to the German population it was 3.63 million persons who were diagnosed with osteoporosis (4.45% of the German population), of whom 82.67% were women and 17.33% men. The adjusted incidence of patients with a new osteoporosis diagnosis in the AOK PLUS population in 2016 was 25,621 patients (20,007 female and 5,614 male patients). Extrapolated to the German population, 588,184 patients were newly diagnosed with osteoporosis (8.76 new cases per 1,000 patient years), of which 451,759 were female (13.11 new cases per 1,000 patient years) and 136,425 male (4.01 new cases per 1,000 patient years) patients. A total of 14,962 osteoporosis patients (12,521 women aged ≥55 years and 2,441 men aged ≥60 years) in the AOK PLUS database with osteoporosis diagnosis in 2010 – 2016 were diagnosed with a new (incident) vertebral or femoral fx in 2016 (Germany: 333,702 patients; 275,785 women aged ≥55 years and 57,917 men aged ≥60 years). At high risk of fracture(s) according to DVO guidelines were 60,408 female (aged ≥55 years; 22,599 with prevalent vert/fem fx; 36,190 with osteoporosis medication (OP med); 1,619 patients with GIOP) and 7,123 male (aged ≥60 years; 3,874 with prevalent vert/fem fx; 2,747 with OP med; 502 patients with GIOP) osteoporosis patients (extrapolated to the German population: 1.16 Mio female (aged ≥55 years) and 0.16 Mio male (aged ≥60 years)).

Discussion:

With our study we could extrapolate a number of 3.63 Mio patients prevalent with osteoporosis in 2016, solely based on ICD-10 codes M80.*/M81.* codes. Of them, 1.32 Mio were assumed to be at high risk for fractures, so that they should receive an osteoporosis medication according to the DVO guidelines.