The direct and indirect costs of osteoporosis in the Iranian population: an economic analysis from a social perspective

Osteoporosis is defined as a systematic skeletal disease and has a high prevalence in Iran. This study aimed to calculate the economic burden of osteoporosis in patients referred to the Bone Mineral Densitometry referral center at Shahid Motahari Clinic, anonymized, in 2023. This study was a cost-of-illness study conducted cross-sectionally from a societal perspective in Shiraz in 2023. Overall, 252 patients with osteoporosis were examined through a census approach. For the cost data, both a prevalence-based approach and a bottom-up approach were employed. Cost data were obtained using information from patient records and insurance bills, as well as based on self-reports from patients or their companions. The human capital approach was used to calculate the cost of work productivity. The results showed that the annual cost of this disease per patient was $5,223 PPP. The largest share of costs was attributed to direct medical expenses (42.75%), with hospitalization costs accounting for the highest proportion of these expenses (53.93% of total healthcare costs). The shares of Direct non-medical costs and Cost of work productivity were 38.51% and 18.74%, respectively. Furthermore, the economic burden of the disease in the country for this year was estimated at $15,749,838,044 PPP. According to the results, osteoporosis can impose a significant economic burden on society and the patients and their families. Therefore, it is recommended to manage treatment strategies, implement preventive measures, and use better insurance coverage for osteoporosis medications to reduce the costs.