Methodology for estimating current and future burden of osteoporosis in state populations: Application to Florida in 2000 through 2025

Objectives: The aging population is expected to increase the burden of osteoporosis on the US health-care system. We developed a methodology for estimating current and future costs of osteoporosis in state populations and applied it to Florida. Methods: We used Florida hospital, population and mortality data, along with national data on outpatient and long-term care, to estimate the cost of osteoporotic fractures in the year 2000. For men and for "other" fractures in women, costs were based on the incidence of hospital admissions for fractures. For hip, spine, and wrist fractures in women, we integrated hospital and nonhospital fracture incidence in a Markov model of osteoporosis. Consecutive cohorts were run by race for each age, 50 to 99 years, to estimate the number and cost of incident fractures. Ongoing costs of prevalent fractures in women were estimated using postfracture health states for each individual age cohort. Total costs and fractures for the years 2001 through 2025 were projected by multiplying the base-year cost and fracture distribution by age-, sex-, and race-specific population growth rates. Results: In Florida, 86,428 osteoporotic fractures were estimated to occur in the year 2000 at a cost of $1,238,445,114. By 2025, the estimated number of incident fractures would increase to 151,622, at a cost of $2,135,130,564. Conclusions: This disease-modeling approach generates detailed information on the current and future cost burden of osteoporosis for an individual state population. Predictions based on this methodology may enable health-policy decisions that are tailored to local needs.