Marginal Health Care Expenditures and Health-Related Quality of Life Burden in Patients with Osteoporosis in United States.

Abstract

Background: Osteoporosis, marked by reduced bone density, significantly impacts quality of life. Recent estimates on its economic and humanistic burden in the United States (US) are scarce.

Objective: To evaluate the marginal burden of osteoporosis on total all-cause health care costs and health-related quality of life (HRQoL) in the US.

Methods: This retrospective cross-sectional study utilized 2019-2021 MEPS data, including adults aged ≥50 years with or without osteoporosis. HRQoL was assessed using physical component summary (PCS) and mental component summary (MCS) scores. Descriptive analyses reported sociodemographic/clinical characteristics, healthcare expenditures, and PCS/MCS scores. A two-part model assessed the marginal effect of osteoporosis on total healthcare expenditures. Multivariable generalized linear model (GLM) estimated the marginal differences in MCS and PCS scores between the osteoporosis and non-osteoporosis groups, while multivariable linear regression assessed factors associated with HRQoL among patients with osteoporosis.

Results: There were approximately 2.89 million patients with osteoporosis and 25 million without osteoporosis. The marginal total health care expenditures were $8,572.15 (95% CI: $6,546.39-$14,597.92) higher for the osteoporosis versus non-osteoporosis group. Age, sex, marital status, year, and certain comorbidities were significant predictors of HRQoL among osteoporosis patients. Multivariable GLM indicated PCS scores were 6.29 units lower (95% CI: -7.08- -4.15) and MCS scores were 4.22 units lower (95% CI: -8.34- -3.31) among osteoporosis versus non-osteoporosis patients.

Conclusion: Patients with osteoporosis showed higher economic burden and lower HRQoL than those without, highlighting the need for policy changes and innovative approaches to improve HRQoL and reduce healthcare expenses for osteoporosis management.