Abstract
Summary
This study reports the direct costs related to osteoporosis and hip fractures paid for governmental and private institutions in the Mexican health system and estimates the impact of these entities on Mexico. We conclude that the economic burden due to the direct costs of hip fracture justifies wide-scale prevention programs for osteoporosis (OP).
Methods
To estimate the total direct costs of OP and hip fractures in the Mexican Health care system, a sample of governmental and private institutions were studied. Information was gathered through direct questionnaires in 275 OP patients and 218 hip fracture cases. Additionally, a chart review was conducted and experts’ opinions obtained to get accurate protocol scenarios for diagnoses and treatment of OP with no fracture. Microcosting and activity-based costing techniques were used to yield unit costs.
Results
The total direct costs for OP and hip fracture were estimated for 2006 based on the projected annual incidence of hip fractures in Mexico. A total of 22,233 hip fracture cases were estimated for 2006 with a total cost to the healthcare system of US$ 97,058,159 for the acute treatment alone ($4,365.50 per case). We found considerable differences in costs and the way the patients were treated across the different health sectors within the country.
Conclusion
Costs of the acute treatment of hip fractures in Mexico are high and are expected to increase with the predicted increment of life expectancy and the number of elderly in our population.
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Acknowledgements
The authors gratefully acknowledge Drs. Luis Guillermo Ibarra, Director General of the National Institute of Rehabilitation SS, Dr. Erick J. Hazan Larsi, Dr. José M. Aguilera Zepeda, and Dr. Pilar Diez Garcia, National Institute of Rehabilitation, Dr. Miriam America Ruiz Esparza, Head of the Osteoporosis Clinic at Centro Medico la Raza, IMSS, and Dr. Alejandro Rios Leal, Head of Hip Surgery from Angeles Mocel for their considerable support in carrying out this study. This study was supported by a grant from CONACYT Sectorial-076, FOFOI, IMSS 2003/33, and a small grant from the International Clinical Epidemiology Network (INCLEN).
Conflict of interest disclosure
Dr. Tugwell organizes a biannual outcome measures consensus meeting - OMERACT (Outcome Measures in Rheumatology)- which has received financial support from: 3-M Pharma, Abbott, Abgenix, Actelion, Alderbio, Alexion Pharmaceuticals, Amgen, Anergen, Apple Centerpoint Maastricht, Astellas, Astra, Astra Zeneca, Aventis, Bayer Corp., Bio-Magnetic Therapy Systems, Boehringer Ingleheim, Boots UK, Bristol Myers Squibb, Burroughs Wellcome, Celltech, Centacor Inc., Ciba Geigy, Combinatorx, Cypress, Dupont, Eli Lilly, Forest Labs, Genelabs Tech, Genentech, Genzyme, Hoechst Marion Roussel, Hoffman-La Roche Ltd., Hologic, IDEC Pharmaceuticals, Immune Response Corp., Immunex, Kabi Pharmacia, Knoll AG, Laboratoires OM, LaJolla Pharmaceutical, Merck, Merck Frosst, Noric Merrell Dow, Novartis, Organon, Ortho-Mcneil Inc., Pfizer, Pharmacia and Upjohn, Pierre Fabre, Procter & Gamble, Purdue Frederick, R.W. Johnson Pharmaceutical, Regeneron, Roche, Roussel UCLAF, Salazopyrin Pharmacia, Sandoz Pharma Ltd., Sanofi Winthrop, Savient, Scarle, Seragen, Smithkline Beecham, Synergen Inc., Syntex Laboratories, Targeted Genetics, Takeda, Wyeth-Ayerst, and Zoma.
Dr. Tugwell has acted as a paid consultant for: Abbott, Almirall, Astra Zeneca, Aventis, Berlex, Biomatrix, Bristol Myers Squibb, Cadeuceus Group, Canadian Coordinating Office for HTA, Canadian Medical Association, Centocor, Dimedix, Dimethaid, Eli Lilly, Glaxo Smith Kline, Glaxo-Welcome, Hoechst Marion Roussel, Innovus, Johnson & Johnson, Lilly Research, Medicine Group, Medicus, Merck, Merck Frosst, Novartis, Novopharm, Ortho Mcneil, Pennsido, Roche, Sandoz, Selos, Searle, Teva Pharmaceuticals, and Wyeth Ayerst.
Dr. Tugwell and his staff have worked on grants supported by: Arthritis Society of Canada, Aventis (HMR), Biomatrix, Canadian Institute of Health Research, Canadian International Development Agency, CIGNA, Council on Health Research and Development, Genzyme, IDRC, Medical Research Council of Canada, Merck, Novartis, Parke Davis, Pfizer, Physiotherapy Foundation of Canada, Rhone-Poulenc, Royal College of Physicians & Surgeons, Sandoz Pharmaceuticals, and Smithkline Beecham.
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Clark, P., Carlos, F., Barrera, C. et al. Direct costs of osteoporosis and hip fracture: an analysis for the Mexican healthcare system. Osteoporos Int 19, 269–276 (2008). https://doi.org/10.1007/s00198-007-0496-8
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DOI: https://doi.org/10.1007/s00198-007-0496-8