The Epidemiology of Osteoporosis-Bone Evaluation Study (BEST) An Analysis of Routine Health Insurance Data

Background: Osteoporosis is a widespread disease of the skeleton that becomes more common with advancing age. Its prevalence is still inadequately documented. The goal of this study is to determine how common osteoporosis is in Germany. Methods: The routine billing data of a large statutory health insurance carrier in Germany (the TK company) from the years 2006 to 2009 were anonymized and retrospectively analyzed. Insurees aged 50 and above with osteoporosis were identified either from their bearing the diagnosis of osteoporosis or of osteoporosis-related fractures, or from their having received prescription medication for osteoporosis. The prevalence and incidence of osteoporosis and the frequency of osteoporotic fractures were calculated for TK insurees and extrapolated to the overall German population. Results: The prevalence of osteoporosis among persons aged 50 and above, as revealed by diagnoses of osteoporosis or osteoporotic fractures, or by the prescription of medication for osteoporosis, was found to be 14% (240 657 of 1.7 million insurees) in the year 2009; the sex-specific prevalence was 24% in women and 6% in men. An extrapolation of these figures implies that 6.3 million persons in Germany have osteoporosis. The incidence of osteoporosis in the same age group, as revealed by a diagnosis of osteoporosis or prescription of medication for osteoporosis, was found to be 2.1% per year, with 104 528 insurees having an index event for osteoporosis (initial diagnosis of osteoporosis or first prescription of a medication for osteoporosis). An extrapolation of this figure implies that 885 000 persons newly develop osteoporosis in Germany each year. Over the period of observation, 52% of the affected persons (total, 172 473 persons) sustained fractures, many of which were multiple. Conclusion: Osteoporosis is still common in Germany. The large number of insurees with single and multiple fractures implies that the treatment of this disease in Germany needs to be improved.