Fragility fractures in Europe: burden, management and opportunities

Abstract

This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five countries of the European Union plus Sweden (EU6). In 2017, new fragility fractures in the EU6 are estimated at 2.7 million with an associated annual cost of €37.5 billion and a loss of 1.0 million quality-adjusted life years. Introduction Osteoporosis is characterized by reduced bone mass and strength, which increases the risk of fragility fractures, which in turn, represent the main consequence of the disease. This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five EU countries and Sweden (designated the EU6). Methods A series of metrics describing the burden and management of fragility fractures were defined by a scientific steering committee. A working group performed the data collection and analysis. Data were collected from current literature, available retrospective data and public sources. Different methods were applied (e.g. standard statistics and health economic modelling), where appropriate, to perform the analysis for each metric. Results Total fragility fractures in the EU6 are estimated to increase from 2.7 million in 2017 to 3.3 million in 2030; a 23% increase. The resulting annual fracture-related costs (€37.5 billion in 2017) are expected to increase by 27%. An estimated 1.0 million quality-adjusted life years (QALYs) were lost in 2017 due to fragility fractures. The current disability-adjusted life years (DALYs) per 1000 individuals age 50 years or more were estimated at 21 years, which is higher than the estimates for stroke or chronic obstructive pulmonary disease. The treatment gap (percentage of eligible individuals not receiving treatment with osteoporosis drugs) in the EU6 is estimated to be 73% for women and 63% for men; an increase of 17% since 2010. If all patients who fracture in the EU6 were enrolled into fracture liaison services, at least 19,000 fractures every year might be avoided. Conclusions Fracture-related burden is expected to increase over the coming decades. Given the substantial treatment gap and proven cost-effectiveness of fracture prevention schemes such as fracture liaison services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are appropriately assessed and treated.

Dual Effects of Lipid Metabolism on Osteoblast Function

“…The tremendous economic impact of osteoporotic fractures (7)(8)(9) and development of comorbidities after fracture (10)(11)(12) highlight the need to understand the genetic, cellular, and endocrine mechanisms that influence bone mass. With the renewed interest in intermediary metabolism in cancer (13)(14)(15) and the recognition that bone is not merely a structural organ acting as a reserve of minerals but also an endocrine organ that can influence systemic metabolism (16)(17)(18)(19)(20)(21), research in the field of skeletal biology has coalesced over the last few years on the contributions of cellular metabolism to osteoblast function and bone formation.…”

A Dairy Product to Reconstitute Enriched with Bioactive Nutrients Stops Bone Loss in High-Risk Menopausal Women without Pharmacological Treatment

“…Osteoporosis is therefore a major health problem, as it not only affects the health and quality of the life of sufferers, but also there are the negative impacts of the associated economic costs and the social problems of treatment. In 2010, the International Osteoporosis Foundation (IOF), together with the European Federation of Pharmaceutical Industry Associations (EFPIA), described the economic burden of the disease in the countries of the European Union and concluded that osteoporosis, as a whole (fractures, drug treatment and long-term care) costs 37 billion euros annually, and will increase by 25% in 2025 [5].…”

Are fragility fractures being treated properly?

“…The number of fragility fractures and cases of osteoporosis is increasing worldwide, creating an increasing burden to society. [2] The risk of refracture is highest immediately after a fracture. This suggests that there is an opportunity to optimize the benefits of fracture prevention by treating patients as soon as possible after occurrence of a fracture.…”

“…In France, Sweden, and Spain, 85%, 84%, and 72% of fracture patients remained untreated one year after fracture, respectively. [2] Citation: Atik OŞ, Aslan A, Odluyurt M. Are fragility fractures being treated properly? Jt Dis Relat Surg 2020;31(2):403-404.…”

“…The evidence suggests that FLSs are cost-effective care delivery models that have the potential to increase the number of high-risk patients being treated, improve adherence to treatment, and reduce the risk of refracture. [2] A FLS provides an opportunity to improve early post fracture patient identification and reduce the treatment gap.…”