A Nationwide Study on the Consumption and Expenditure of Osteoporosis Medications in Iran During the Period From 2001 to 2021 Publisher Pubmed



Mousavi A ; Kargar M ; Fahimfar N ; Ostovar A ; Akbari Sari A ; Daroudi R
Source: Archives of Osteoporosis Published:2025

Abstract

Summary : Anti-osteoporosis medications (AOM) play a crucial role in the management of osteoporosis. The utilization of AOM in Iran has shown an overall increasing trend over time, albeit with fluctuations. However, underutilization is a fundamental challenge. Alendronate has consistently been the most widely used medication. Purpose: Anti-osteoporosis medications (AOM) play a crucial role in the management of osteoporosis. This study investigates the patterns of consumption and expenditures of these agents in Iran. Methods: The wholesale data of the Iran Food and Drug Administration on the consumption and costs of AOM from 2001 to 2021 was investigated. Annual utilization of medications was converted to defined daily doses (DDDs) per 1000 individuals per day (DID). Adequacy of treatment was also calculated based on the proportion of post-menopausal patients who received a DDD per day of AOMs. Data were analyzed using descriptive statistics and Excel software. Results: The consumption and expenditure of AOM exhibited a fluctuation pattern. AOM utilization increased from 0.2 to 3.68 DID in 2021, indicating a rise of 19 times. Alendronate was consistently the most widely used medication, maintaining a share of > 90% from 2005 to 2015. With the increasing share of zoledronic acid and denosumab, the share of alendronate reduced in the last 5 years. In 2021, the AOM expenditure amounted to US$ 42.72 million purchasing power parities (PPP). In recent years, denosumab and teriparatide accounted for the majority of the expenditure. Majority of patients (84.25–97.54%) did not receive adequate treatment in the study period. Conclusions: The utilization of AOM in Iran has shown an overall increasing trend over time, albeit with fluctuations. However, underutilization is a fundamental challenge. Given the impact of these medications on osteoporosis treatment and fracture reduction, it is imperative to identify patients and ensure timely and effective medication treatment. © 2025 Elsevier B.V., All rights reserved.