Bone evaluation study-2: update on the epidemiology of osteoporosis in Germany

Abstract

Osteoporosis is the most common bone disorder. Our data gives an estimate of around 5.87 million cases of osteoporosis in the general German population in 2018. Only 30% of insured individuals who suffered an osteoporotic fracture and/or had a confirmed diagnosis of osteoporosis, received an appropriate prescription.

Purpose: Osteoporosis is the most common bone disorder. It particularly affects elderly people and increases the risk of atraumatic fractures. The aim of this study was to estimate the prevalence of osteoporosis in the general German population aged ≥ 50 years and to collect data on the frequency of prescription of osteoporosis-specific medication in order to assess the treatment gap.

Methods: Retrospective analysis of anonymized data of individuals aged ≥ 50 years insured under statutory healthcare schemes from the database of the Institute for Applied Health Research Berlin (InGef) for 2018 (study population). Insured individuals with osteoporosis were identified based on osteoporosis diagnoses, osteoporosis-specific prescriptions, or osteoporotic fractures. Thus, we estimated the prevalence of osteoporosis in the general German population aged ≥ 50 years. The prevalence of diagnoses, fractures, and prescriptions was determined for the study population and stratified by age and gender.

Results: Within the study population of 1,599,299 insured individuals, a prevalence of osteoporosis of 15.9% was determined. This estimated approximately 5.87 million cases of osteoporosis for the general German population. 81.6% of the cases were women. Osteoporosis-specific prescriptions were received by 30.0% of the insured individuals in the study population who had been diagnosed with osteoporosis and/or suffered an osteoporotic fracture.

Conclusions: Germany has a high prevalence of osteoporosis. Only a small portion of individuals who may require osteoporosis-specific treatment actually receive it.

Keywords: Care gap; Fracture; Osteoporosis; Prevalence; Secondary analysis.

Fig. 1

Insured individuals from the InGef database who were included in this analysis. Gender share and age distribution in the study population for the year 2018. Adapted from [1]

Fig. 2

Key characteristics of the study population for the year 2018, stratified by age and gender. A Prevalence of osteoporosis diagnosis. B Prevalence of osteoporotic fractures. C Prevalence of osteoporosis-specific prescriptions. A–C The stratified data are relative to the number of insured individuals in the age and gender-appropriate population (see Fig. 1). # Based on n = 1,559,299. A and B modified from [1]

Fig. 3

Prevalence of osteoporosis, estimated for the German population ≥ 50 years for the year 2018. The following cases were considered as osteoporosis: individuals with osteoporosis = osteoporosis-specific prescription and/or the diagnosis of an osteoporotic fracture and/or the diagnosis of osteoporosis. The prevalence in the total population was determined based on the number of individuals aged ≥ 50 years, who were living in Germany in 2018. Total: n = 36,851,612; men: n = 17,283,769; women: n = 19,567,843. ^# The case numbers of men and women add up to 5,796,341 cases. This deviation from the total number arises from the calculation method used and the rounding effects. Modified from [1]

Fig. 4

Additional key characteristics of the study population for the year 2018, stratified by age and gender. A Prevalence of osteoporosis diagnoses among insured individuals who suffered an osteoporosis-specific fracture. B Prevalence of osteoporosis-specific prescriptions among insured individuals with an osteoporosis diagnosis. C Prevalence of osteoporosis-specific prescriptions among insured individuals with an osteoporosis diagnosis and/or an osteoporotic fracture. A and C adapted from [1]