Increase in prescriptions for osteoporosis and reduction in hip fracture incidence in Hong Kong during 2005-2014

Abstract

AIM: Ageing of the population makes osteoporosis and the consequent hip fractures a growing problem. In clinical trials, drugs for osteoporosis typically halved the risk of hip fractures. Generic bisphosphonates are thought to be cost-effective in reducing fractures and subsequent complications. Therefore, we studied the trends in the prescription of drugs for osteoporosis and the incidence of hip fractures. METHODS: We used the data from 2005 to 2014 of the computerised database of the Hong Kong Hospital Authority. Hip fracture rates were adjusted to the 2006 Hong Kong population structure. RESULTS: In 2014, 84% of the drugs prescribed for osteoporosis were bisphosphonates. The annual number of bisphosphonate prescriptions increased from 3888 in 2005 to 32 389 in 2014. The age-adjusted incidence of hip fracture in women aged ≥60 years decreased from 426.6 per 100 000 people in 2005 to 276.7 per 100 000 people in 2012, and levelled off in the range between 270.5 and 281.8 per 100 000 people in 2012-2014. The hip fracture incidence in men aged ≥60 years also decreased, from 197.4 in 2005 to 142.5 per 100 000 in 2009 and levelled off in the range of 130 to 150 in 2009-2014 per 100 000. There was a significant reciprocal relationship between the number of typical hip fractures and the number of bisphosphonate prescriptions (r=0.94, P < 0.001 in both men and women). CONCLUSION: In the past decade in Hong Kong, the age-adjusted incidence of hip fractures decreased, which is associated with increased use of bisphosphonates for osteoporosis.