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Fracture Prevention in a Super-Aging Society: Insights from Studies of Health Incurance Claims Data and Cost-Effectiveness Analysis

Research Project

Project/Area Number 20K10340
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 58010:Medical management and medical sociology-related
Research InstitutionInternational University of Health and Welfare (2022-2023)
Chiba University (2021)
University of Tsukuba (2020)

Principal Investigator

Mori Takahiro  国際医療福祉大学, 医学部, 教授 (50384780)

Co-Investigator(Kenkyū-buntansha) 田宮 菜奈子  筑波大学, 医学医療系, 教授 (20236748)
藤井 朋子  国士舘大学, 体育学部, 教授 (40793089)
Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2022: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Keywords骨折予防 / 医療介護レセプト / 費用対効果分析 / 大腿骨骨折 / 骨粗鬆症 / 脆弱性大腿骨近位部骨折 / 骨粗鬆症薬物治療 / 年間医療費 / 医療経済学 / テリパラチド / 医療介護レセプト研究 / 超高齢化社会
Outline of Research at the Start

我が国にて医療・介護費の総額は年間52兆円を超え(2017年度)、大きな社会問題である。また骨粗鬆症の有病者数は約1280万人と推定されており、骨折は要介護に至る主因であり医療・介護費の増大をもたらす。

我が国では骨折予防に関する費用対効果分析に必要なパラメーター(骨折の医療・介護費や治療薬の継続率など)の先行研究が不足している。本研究では医療・介護レセプト(地方自治体、全国)を用いて骨折に関するパラメーターの算出を進め、その結果を用い骨折予防に関する費用対効果分析を実施する。

本研究は、超高齢社会における骨折予防に関して医療経済学の視点からエビデンスの蓄積に貢献する。

Outline of Final Research Achievements

As the products of this Kaken project, four manuscripts have been published in Archives of Osteoporosis, which is a prestigious journal in the field of osteoporosis. Among high-risk osteoporotic women in Japan, sequential teriparatide/alendronate was not cost-effective compared with alendronate monotherapy, even with the availability of biosimilar teriparatide. Among older osteoporotic women without prior fragility fracture in Japan, zoledronic acid was cost-saving compared with sequential denosumab/alendronate. The annual medical expenditure related to hip fractures in Japan was estimated be approximately 329 billion yen, using the nationwide health insurance claims database in Japan. Pharmacotherapy for osteoporosis was less likely to be initiated after a hip fracture in male patients and patients with dementia, while an admission to rehabilitation wards was associated with pharmacotherapy initiation.

Academic Significance and Societal Importance of the Research Achievements

全国規模の医療レセプトデータを解析した研究では、大腿骨骨折に関連する我が国の年間医療費を約3290億円と算出した。同様の方法で我が国の疾患ごとの年間医療費を算出した先行研究は筆者の知る限りなく、本研究で用いたアプローチは他の疾患にも応用が可能であり学術的な意義が大きい。本研究の主たる目的は、我が国の超高齢社会における骨粗鬆症の治療や骨折予防に関して、特に医療経済学の視点からエビデンスの蓄積に貢献することであった。本研究で示された結果は、臨床家にとって日々の臨床現場での判断材料になるだけでなく、エビデンスに基づく政策にも役立ち、社会的意義も大きい。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (6 results)

All 2023 2022 2021 Other

All Int'l Joint Research (1 results) Journal Article (4 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 4 results,  Open Access: 4 results) Presentation (1 results)

  • [Int'l Joint Research] University of California, Los Angeles/VA Greater Los Angeles Healthcare System(米国)

    • Related Report
      2021 Research-status Report
  • [Journal Article] Factors associated with non-initiation of osteoporosis pharmacotherapy after hip fracture: analysis of claims data in Japan2023

    • Author(s)
      Fujii Tomoko、Mori Takahiro、Komiyama Jun、Kuroda Naoaki、Tamiya Nanako
    • Journal Title

      Archives of Osteoporosis

      Volume: 18 Issue: 1 Pages: 103-103

    • DOI

      10.1007/s11657-023-01314-x

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Medical expenditures for fragility hip fracture in Japan: a study using the nationwide health insurance claims database2022

    • Author(s)
      Mori Takahiro、Komiyama Jun、Fujii Tomoko、Sanuki Masaru、Kume Keitaro、Kato Genta、Mori Yukiko、Ueshima Hiroaki、Matsui Hiroki、Tamiya Nanako、Sugiyama Takehiro
    • Journal Title

      Archives of Osteoporosis

      Volume: 17 Issue: 1 Pages: 61-61

    • DOI

      10.1007/s11657-022-01096-8

    • Related Report
      2022 Research-status Report 2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan2021

    • Author(s)
      Takahiro Mori, Carolyn J. Crandall, Tomoko Fujii, David A. Ganz
    • Journal Title

      Archives of Osteoporosis

      Volume: 16 Issue: 1 Pages: 113-113

    • DOI

      10.1007/s11657-021-00956-z

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Cost-effectiveness of sequential daily teriparatide/weekly alendronate compared with alendronate monotherapy for older osteoporotic women with prior vertebral fracture in Japan2021

    • Author(s)
      Mori Takahiro、Crandall Carolyn J.、Fujii Tomoko、Ganz David A.
    • Journal Title

      Archives of Osteoporosis

      Volume: 16 Issue: 1 Pages: 72-72

    • DOI

      10.1007/s11657-021-00891-z

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] レセプトデータを用いた大腿骨近位部骨折後の骨粗鬆症薬物治療導入の有無に関連する要因の検討2023

    • Author(s)
      藤井朋子 森隆浩 小宮山潤 黒田直明 田宮菜奈子
    • Organizer
      第25回日本骨粗鬆症学会
    • Related Report
      2023 Annual Research Report

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Published: 2020-04-28   Modified: 2025-01-30  

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