{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T14:01:09Z","timestamp":1758808869992,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,6,9]],"date-time":"2015-06-09T00:00:00Z","timestamp":1433808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004436","name":"Commonwealth Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004436","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["R01 HS018657"],"award-info":[{"award-number":["R01 HS018657"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Institute of Medicine","award":["IOM-2000000523"],"award-info":[{"award-number":["IOM-2000000523"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims and objectives<\/jats:title><jats:p>Biologics are substantially more expensive than their conventional counterparts but it is unclear whether extra costs deliver better health outcomes. We compare clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a 5% random sample of <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edicare beneficiaries, we selected women newly diagnosed with osteoporosis between 1 <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2007 and 31 <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2011 and who initiated teriparatide or bisphosphonates after the diagnosis. We followed them up until one of these events: switching osteoporosis treatment, death, or the end of study period \u2010 31 December 2011. Clinical outcomes included hip fracture, vertebral fracture, fracture of radius, ulna or carpal bones, other upper limb fractures, other lower limb fractures and any fracture. Economic outcomes included medical costs, pharmacy costs, and total costs associated with osteoporosis. Using conventional propensity score, high\u2010dimensional propensity score and instrumental variable analysis, we constructed <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox proportional hazards models to evaluate the risk of fracture and two\u2010part models to compare costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Teriparatide users had higher risk of fracture and higher costs, compared with similar bisphosphonates users. The hazard ratios of fracture for teriparatide relative to bisphosphonates ranged from 1.37 to 2.12, depending on methods. There was no difference in the risk of hip fracture between treatment groups. Total annual costs related to osteoporosis were between $2733 and $3352 higher for teriparatide users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The biological agent, teriparatide, is more expensive yet less effective than conventional treatment, bisphosphonates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12389","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T21:19:17Z","timestamp":1433971157000},"page":"840-847","source":"Crossref","is-referenced-by-count":5,"title":["Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis"],"prefix":"10.1111","volume":"21","author":[{"given":"Inmaculada","family":"Hernandez","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0804261"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.1.w151"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.25.5.1291"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4065\/83.9.1032"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-020334"},{"issue":"8","key":"e_1_2_7_7_1","first-page":"1556","article-title":"Longterm reduction of back pain risk in women with osteoporosis treated with teriparatide compared with alendronate","volume":"32","author":"Miller P. D.","year":"2005","journal-title":"The Journal of Rheumatology"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.11.1209"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001980070097"},{"key":"e_1_2_7_10_1","unstructured":"Centers for Medicaid and Medicare Services(2011)27 Chronic condition algorithm. Chronic Conditions Data Warehouse.Available at:http:\/\/www.ccwdata.org\/cs\/groups\/public\/documents\/document\/ccw_conditioncategories2011.pdf(last accessed 11 May 2015)."},{"issue":"1","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.18553\/jmcp.2011.17.1.25","article-title":"The association of adherence to osteoporosis therapies with fracture, all\u2010cause medical costs, and all\u2010cause hospitalizations: a retrospective claims analysis of female health plan enrollees with osteoporosis","volume":"17","author":"Halpern R.","year":"2011","journal-title":"Journal of Managed Care Pharmacy"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10729-009-9121-z"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12071"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.4.1214"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2011.06.027"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8721.ep10768783"},{"key":"e_1_2_7_18_1","unstructured":"Deb P. Manning W.&Norton E.(2010)Minicourse: modelling health care costs and counts. American Society of Health Economists Conference Cornell."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000135174.63482.43"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-005-0066-x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e3181c617e6"},{"key":"e_1_2_7_22_1","unstructured":"NICE technology appraisal guidance(2008)Alendronate etidronate risedronate raloxifene strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. Available at:https:\/\/www.nice.org.uk\/guidance\/ta161\/chapter\/1\u2010guidance(last accessed 20 March 2015)."}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjep.12389","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjep.12389","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.12389","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T18:15:17Z","timestamp":1696270517000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.12389"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,9]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1111\/jep.12389"],"URL":"https:\/\/doi.org\/10.1111\/jep.12389","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"type":"print","value":"1356-1294"},{"type":"electronic","value":"1365-2753"}],"subject":[],"published":{"date-parts":[[2015,6,9]]}}}