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Report reveals ‘immense burden’ of osteoporotic fractures in Europe
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The economic burden of fractures in Europe has been significantly underestimated, according to a report launched by the International Osteoporosis Foundation and the European Federation of Pharmaceutical Industry Associations.
The report examined epidemiological and health economic aspects of osteoporosis and osteoporotic fractures in Europe — specifically, France, Germany, Italy, Spain, Sweden and the United Kingdom. According to an International Osteoporosis Foundation (IOF) press release, researchers concluded 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 attributed 80 deaths per day to fragility fractures.
“This landmark report exposes a number of major issues and challenges related to health care provision for fragility fractures,” John Kanis, IOF president, stated in the release. “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 aging population.”
Key findings regarding economic and health costs of fragility fractures for the six countries studied include:
- For the year 2010, approximately 2.5 million new fractures occurred, with approximately 34,000 deaths being caused by fractures — 49% following hip fractures;
- The reported total health burden of osteoporotic fractures measured in quality-adjusted life years was estimated at 850,000;
- Health care cost, including pharmacological prevention, was estimated at 3.5% of the total spending on health care;
- Despite the existence of management guidelines, the report noted a minority of patients actually receive medical treatment to prevent fractures;
- The projected number of fractures in 2025 is 3.2 million — an increase of 29%;
- The improved implementation of clinical guidelines to close the treatment gap has been found cost-effective and could save nearly 700,000 fractures by 2025; and
- The economic burden of osteoporotic fractures exceeds those for migraine, stroke, multiple sclerosis and Parkinson’s disease — and is similar to the burden of rheumatoid arthritis.
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Recognizing missed opportunities to spread awareness may be an integral way to improve implementation of clinical guidelines. Chest radiography, for example, often reveals fractures, but many go unreported. In addition, physicians may fail to discuss how certain treatments, such as those for breast cancer and prostate cancer, raise the risk for osteoporosis and monitor their patients accordingly. Furthermore, unlike with hypertension and cholesterol, a patient must be referred to someone else for a bone desnity test to measure the risk for fracture, which is not routine in primary care practice. Osteoporosis is also typically perceived as ‘an old lady’s disease,’ and therefore, it is often overlooked as a diagnosis in certain populations. Moreover, media reports and news articles often do not discuss the disease, even when describing high-profile cases of fracture involving public figures. At present, many physicians are unsure of how to overcome these issues, but many hope that the introduction of new tools such as electronic medical records may help mitigate the problem.
– Michael Kleerekoper, MD, MACE
Endocrine Today Editorial Board member
Disclosure: Dr. Kleerekoper reports no relevant financial disclosures.
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