Osteoporosis medicines

Page last updated: 3 March 2017

Drug utilisation sub-committee (DUSC)

September 2016



To review the utilisation of medicines for the treatment of osteoporosis including an assessment of the predicted and actual use of denosumab.

Date of first listing on the Pharmaceutical Benefits Scheme (PBS) for the treatment of osteoporosis

  • Calcitriol: 1 December 1991
  • Disodium etidronate and calcium carbonate: 1 August 1996 (delisted September 2012)
  • Alendronate: 1 November 1996
  • Raloxifene: 1 November 1999
  • Risedronate: 1 February 2001
  • Risedronate and calcium carbonate: 1 April 2006
  • Alendronate with colecalciferol: 1 August 2006
  • Strontium: 1 April 2007 (delisted 1 August 2016)
  • Risedronate and calcium carbonate with colecalciferol (1 May 2008)
  • Zoledronic acid: 1 December 2008
  • Teriparatide: 1 May 2009
  • Alendronate with colecalciferol and calcium carbonate: 1 June 2010
  • Denosumab: 1 December 2010

Data Source / methodology

Patient counts and patient level analysis data were extracted from the Department of Human Services (DHS) prescription database for prescriptions supplied from January 2003 to March 2016. Prescription and expenditure analyses were based on prescriptions supplied from January 1990 to March 2016.

Key Findings

  • Rates of treatment with osteoporosis medicines declined by 15% between 2007 and 2014 despite reports of increasing prevalence of osteoporosis. In 2015 the treatment rate increased. Further data will be needed to confirm if this increase is sustained. 
  • In 2015, 471,497 patients were treated with osteoporosis medicines through the PBS, and 15% of these people (72,132) commenced osteoporosis treatment for the first time.
  • The average age when starting osteoporosis medicines was 71 years. This was similar between men and women.
  • Osteoporosis was more prevalent in women than men, with an estimated prevalence ratio in Australia of 3.8:1 for people over 50 years. The ratio of women to men aged 50 years or older treated with PBS osteoporosis medicines in 2015 was 3.9:1.
  • Utilisation of denosumab had been much higher than expected. Approximately half of people starting osteoporosis therapy for the first time in 2015 were prescribed denosumab. A large number of people already on treatment with other medicines had switched to denosumab. In 2015, 57% of patients initiating denosumab had previously used at least one other osteoporosis drug.

Full Report