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

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K10340
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: International 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
• Keywords: 骨折予防 / 医療介護レセプト / 費用対効果分析

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.

Free Research Field

Health Services Research

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。