OBJECTIVES: To describe the utilization and expenditure associated with medicines for the prevention and treatment of osteoporosis in the publically funded healthcare system in Ireland, over a 13-year period.

METHODS: This repeated, cross-sectional study was performed using the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS) national pharmacy claims databases which include the General Medical Services (GMS), the Long-Term Illness (LTI) scheme, the Drugs Payment (DP) scheme, and the High Tech (HT) Arrangement. Data was included on claims from 1st January 2011 to 31 December 2023 for dispensed medicines that are licensed for the management of osteoporosis; bisphosphonates (alendronate, ibandronate, risedronate), teriparatide, denosumab, selective oestrogen receptor modulators (SERMS) (raloxifene, bazedoxifene) and tibolone.

RESULTS: There has been a significant change in the utilization of medicines for the treatment of osteoporosis in Ireland over the study period. The number of individual patients in receipt of one of these medicines has increased slightly over the thirteen-year period, from 109,235 patients in 2011 to 127,887 in 2023. The associated annual expenditure was €28.7 million in 2011, increasing to €33.8 million in 2023. However, the distribution of the expenditure has changed significantly. For example, expenditure on denosumab accounted for €0.97 million in 2011 (less than 5% of the annual total), but had increased substantially to €26.4 million in 2023 (almost 80% of the annual total). Due to a decrease in patient numbers and the introduction of cost-containment measures, a decrease in expenditure associated with bisphosphonates was also observed; from almost €18 million in 2011 to €3 million in 2023.

CONCLUSIONS: This study highlights the changing landscape of osteoporosis prevention and treatment in Ireland, over a 13-year period. Further research into treatment adherence with these therapies is warranted, given an aging population and attendant increase in fractures with associated healthcare resource use.