Research Article| Volume 15, ISSUE 3, P97-108, May 2005

Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population


      Postmenopausal women have a significant risk of developing a number of chronic conditions including osteoporosis (OP), breast cancer (BrCa), and cardiovascular disease (CVD). These diseases can result in significant direct (medical treatment) and indirect (workplace) costs. The objective of this study is to assess these costs among an employed population.


      Deidentified medical and disability claims data from seven large employers (n = 585,441) were analyzed from 1998 through 2000 for female employees, age 50–64 years. Medical claim ICD-9CM codes were used to identify patients treated for: OP (n = 2,314), BrCa (n = 555), and CVD (n = 1,710). Each disease cohort was compared to a random sample of 50- to 64-year-old female employees (n = 7,575). Descriptive and multivariate techniques were used to characterize direct and indirect costs attributable to each condition.


      Average annual direct costs were higher (p < .001) for female employees treated for OP ($6,259), BrCa ($13,925), or CVD ($12,055) when compared with the random sample ($2,951). In addition, average annual indirect costs associated with OP ($4,039), BrCa ($8,236), and CVD ($4,990) were higher (p < .001) than indirect costs for the random sample ($2,292). Even when controlling for each disease-state cohort’s demographics and disease-specific comorbidities, patients treated for OP, BrCa, and CVD continued to have significantly greater direct and indirect costs (p < .001) than the random sample.


      Chronic conditions such as OP, BrCa, and CVD, which occur more frequently in women after menopause, impose a significant financial burden. Greater health care utilization and work-loss prevalence among women treated for these conditions contribute to these additional costs.
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      Dr. Sasser is an economist specializing in the development of analytical frameworks and economic models in a variety of settings including health policy evaluations, cost-of-illness studies, and market analyses. She has authored a number of recent manuscripts for publication on the economics of osteoporosis and other illnesses and her work has been presented at several professional conferences including the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), the American Society for Bone and Mineral Research (ASBMR), and the Academy of Managed Care Pharmacy (AMCP).


      Dr. Rousculp is a healthcare research consultant who has conducted several recent pharmacoeconomic studies of osteoporosis and other post-menopausal diseases. He has published numerous manuscripts including papers in JAMA, Journal of American Geriatrics Society, Osteoporosis International, and Human Gene Therapy. Dr. Rousculp currently serves on the Health Science Task Force on Good Research Practices Modeling Studies for the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).


      Dr. Birnbaum is a health care economist with extensive experience in the areas of pharmacoeconomics, cost-of-illness, and health care financing. His work has appeared in numerous leading medical and health economics journals, including Archives of Internal Medicine, Health Affairs, Health Care Financing Review, and the American Journal of Public Health.


      Ms. Oster is a PhD candidate in the Economics Department at Harvard University. She has worked in the areas of pharmacoeconomics and cost of illness and has extensive experience working with large administrative claims databases.


      Dr. Lufkin is an MD specializing in the treatment of osteoporosis. His research has appeared in numerous leading medical journals including Archives of Internal Medicine, Osteoporosis International, Journal of Bone Mineral Research, and Bone.


      Mr. Mallet is an Account Director/Product Manager specializing in the management and dissemination of administrative health care claims data. He has participated in a number of research projects studying the impact of diseases and treatments on health care outcomes in large populations including disease incidence, prevalence, and treatment utilization patterns over time.