Background Developments in anti-osteoporosis medications (AOM) have led to changes in guidelines and policy, which, along with media and marketing strategies, have had an impact upon the prescribing of AOM.
Objectives The aim was to examine patterns of AOM dispensing in older women (aged 76-81 years at baseline) from 2002 to 2010.
Methods Administrative claims data were used to depict patterns of dispensing for each class of AOM in 4649 participants (born in 1921-1926 and still alive in 2011) in the Australian Longitudinal Study on Women’s Health. The patterns were interpreted in the context of changes in guidelines, indications for subsidy, publications (scholarly and general media), and marketing activities.
Results Total use of AOM increased from 120 DDD/1000/day in 2002 to 212 DDD/1000/day in 2007, but then decreased to 182 DDD/1000/day in 2010. Alendronate was the most dispensed AOM but decreased from 2007, while use of risedronate (2002 onward), strontium ranelate (2007 onward) and zoledronic acid (2008 onward) increased. Etidronate and HRT prescriptions gradually decreased over time. The decline in alendronate dispensings coincided with increases of other bisphosphonates and publicity about potential adverse effects of bisphosphonates, despite relaxing indications for bone density testing and subsidy for AOM.
Conclusions Overall dispense of AOM from 2002 reached a peak in 2008 and thereafter declined despite increases in therapeutic options and improved subsidized access. The recent decline in overall AOM dispensing in this group of older Australian women seems to be explained largely by negative publicity rather than specific changes in guidelines and policy.
Disclosure of Interest G. Peeters: None Declared, S. Tett: None Declared, E. Duncan Grant/research support from: has received unrestricted educational grant support for fracture liaison services at Princess Alexandra Hospital (no personal return) from Sanofi-aventis, MSD, Servier and Novartis; has received support for travel for educational meetings from MSD, Sanofi-Aventis and Servier., Consultant for: received support for the Brisbane Bone Group (an educational meeting for Brisbane doctors and scientists, with no personal return) from Sanofi-Aventis, Servier, MSD, Novartis, Amgen, Lilly; has received honoraria for lectures from Sanofi Aventis, MSD, Novartis, Servier, Amgen; has received support for fracture liaison services at Royal Brisbane and Women’s Hospital (no personal return) from Sanofi-aventis, G. Mishra: None Declared, A. Dobson: None Declared