Comparison of the proportion of patients potentially treated with an anti-osteoporotic drug using the current criteria of the Belgian national social security and the new suggested FRAX Ò criteria

Abstract

Abstract To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX Ò or the current criteria were used to determine access to reimbursement. This is a retrospective study based on data from 1,000 women randomly selected from an outpatient hospital specialized in bone metabolism in Belgium. Proportions of potentially refunded treatments between FRAX Ò and current criteria were compared. Out of the 1,000 women files, 890 have sufficient information to assess FRAX Ò . In Belgium, current criteria include a bone mineral density (BMD) T score below -2.5 at the lumbar spine, the femoral neck or the total hip and/or at least a prevalent vertebral fracture. Using these criteria, 167 women (18.8 %) would have access to reimbursement. Using the criteria based on the validated Belgian FRAX Ò tool, only 116 women (13.0 %) would have access to reimbursement, meaning that access to reimbursement based on FRAX Ò criteria would reduce by 30 % the anti-osteoporosis drug expenses covered by the national social security. Interestingly, only 65 women out of the 116 (56.0 %) selected with the FRAX Ò criteria were also selected with the current criteria of the national social security. A substantial proportion of individuals that would potentially receive a reimbursement for their treatment using the FRAX Ò criteria do not have access to any refund for their treatment with the current criteria. Since patients identified with the FRAX Ò tool are those with the highest risk profile for future fractures, reappraisals of treatment reimbursement guidelines are expected in Belgium