Osteoporosis is a common bone disease estimated to have affected 24.5 million U.S. patients in 2014, although owing to the asymptomatic nature of osteoporosis, the disease remains underdiagnosed. U.S. physicians generally follow the guidelines put forth by the American National Osteoporosis Foundation (NOF) (most recently updated in 2014) for the diagnosis and treatment of osteoporosis. The goal of therapy in osteoporosis is ultimately to reduce the risk of fracture, with an emphasis on the more serious and debilitating nonvertebral fractures (e.g., those of the hip or tibia). First-line pharmacological therapy for treating osteoporosis is typically an oral bisphosphonate. Generic alendronate (Merck & Co.’s Fosamax, generics) is the most commonly used first-line therapy in the United States. Since 2012, the osteoporosis market has experienced the entry of numerous generically available treatment options—all but a single branded bisphosphonate now face generic competition. The genericization of the majority of the bisphosphonates will increase pressure on physicians to prescribe these alternatives ahead of more expensive branded options, including Amgen’s Prolia (denosumab).
Using national patient-level claims data, the Treatment Algorithms in Osteoporosis report explores the use of key therapies and drug classes among newly diagnosed and recently treated osteoporosis patient populations. Concerning the newly diagnosed patients, the report provides a quantitative analysis of percentage drug-treated and time to treatment, treatment patterns and share by line of therapy, progression between lines, recent patient-share trends, and use of concomitant treatment. Among recently treated patients, the report quantifies a drug’s overall drug share, use in combination with other therapies, and source of business compared with its competitors, detailing which drugs precede others through an analysis of add-versus-switch patterns. Two additional claims database queries explore persistency and compliance by therapy.