Economic burden of fractures in Europe far higher than previously estimated; fractures result in more costs and disability than many other common chronic diseases

A new report launched today by the International Osteoporosis Foundation (IOF) in collaboration with the European Federation of Pharmaceutical Industry Associations (EFPIA) reveals that the burden of fractures in Europe has been vastly underestimated. The report concludes that in Europe’s five largest countries and Sweden alone, an estimated 2.5 million new fragility fractures occurred in 2010 – the equivalent of 280 fractures per hour. It also showed an astounding eighty deaths per day attributable to fragility fractures.

Osteoporosis: Burden, health care provision and opportunities in the European Union’ examines both epidemiological and health economic aspects of osteoporosis and osteoporotic fractures in Europe, and specifically in France, Germany, Italy, Spain, UK as well as Sweden.

It is estimated that one in three women and one in five men over the age of fifty worldwide will sustain an osteoporotic fracture, often resulting in substantial pain and suffering, disability, and even death. As a result, osteoporosis imposes a significant burden on both the individual and society. IOF President John Kanis stated, “This landmark report exposes a number of major issues and challenges related to health care provision for fragility fractures. What is particularly striking is how the economic burden of fractures has increased in just over a decade. In 2000 the economic burden of fractures for the then European Union was estimated at € 36 billion. The current estimate of € 30.7 billion for just six countries largely reflects the increased number of fractures due to Europe’s ageing population.”

Several of the key findings regarding the economic and health cost of fragility fractures for the six countries studied include:
• For the year 2010 approximately 2.5 million new fractures occurred in the six countries, with approximately 34,000 deaths caused by fractures – 49% following hip fractures
• The total health burden of osteoporotic fractures, measured in quality-adjusted life years (QALY) lost, was estimated at approximately 850,000 QALYs.
• The health care cost, including pharmacological prevention, was estimated at Euro 30.7 billion – corresponding to 3.5% of the total spending on health care in those countries.
• A majority of the total costs was for the acute management of fracture whilst pharmacological prevention and treatment only represented 4.7% of total costs .
• Despite the existence of management guidelines, a minority of patients receive medical treatment to prevent fractures.
• In 2025 the projected number of fractures will increase by 29% reaching 3.2 million fractures, with health care costs increasing to Euro 38.5 billion.
• Improved implementation of clinical guidelines to close this ‘treatment gap’ is cost-effective and could save almost 700,000 fractures by 2025.
• The economic burden of osteoporotic fractures in these countries exceeds those for migraine, stroke, MS, and Parkinson’s disease, and is similar to the burden of rheumatoid arthritis

In six clearly defined chapters, it provides an introduction to osteoporosis and then reviews medical innovation and clinical progress in the management of osteoporosis, the epidemiology and burden of the disease, the current uptake of osteoporosis treatments and the future burden of fractures as a consequence of increasing treatment uptake.

EFPIA Director General Richard Bergström commented, “ In Europe the number of elderly is set to increase markedly, with individuals expected to enjoy a longer life expectancy than ever before. We also know that the incidence of fractures rises progressively with age, and as a result we can expect the economic and social impact of fractures to increase significantly unless action is taken. Fortunately, we have a host of effective diagnostic and treatment options at our disposal – it is time to implement these advances fully. “