Future burden of fractures could be avoided with increased treatment uptake: Study

It pays to prevent fractures. That's one of the main findings of a landmark report 'Osteoporosis - Burden, Healthcare provision and Opportunities in the European Union' newly published in the journal Archives of Osteoporosis. The study, compiled by the International Osteoporosis Foundation (IOF) in collaboration with the European Federation of the Pharmaceutical Industries and Associations (EFPIA), calculates the future burden of fractures as a consequence of increasing treatment uptake in the five largest European countries as well as Sweden.

Fragility fractures, which affect as many as one in three women and one in five men over the age of 50, have immense social and health economic consequences. In the six countries studied, an estimated 2.46 million fragility fractures occurred in 2010 (280 fractures per hour). The result is often severe loss of quality of life, long-term disability, loss of independence, or even early death - in the six countries, 80 deaths per day are attributed to fractures. Fractures are expensive for healthcare systems as they involve immediate medical care, rehabilitation and nursing care for the elderly who may consequently suffer from long-term disability.

Improving treatment uptake to prevent future fractures: Largely due to the ageing of the population, the annual number of fractures in France, Germany, Italy, Spain, the UK and Sweden is expected to increase by 28.9% in 2025 - from a current 2.46 million to approximately 3.17 million. The total monetary burden in these six countries alone is expected to increase from -30.7 Billion in 2010 to -38.5 Billion in 2025.

Low treatment uptake is identified as a major problem. People at high risk of fracture are simply not being identified and referred for preventative treatment, while approximately 50% of those who are identified for pharmacological intervention don't follow their prescribed treatment and/or discontinue treatment within one year.

The report found that increasing treatment uptake to provide all individuals with a 10-year probability of fracture exceeding that of an age and sex-matched individual with a previous fracture with a 3-year treatment would require a 2.4-fold increase in provision of treatment. As a result, a significant number of future fractures could be avoided cost-effectively in the six European countries studied:

• Increasing treatment uptake in the six countries would result in 95,000 fewer fractures and 33,357 Quality of Life Years (QALYs) gained annually in 2025;
• The accumulated number of potentially avoided fractures from increasing uptake up to 2025 was estimated at 699,000;
• 13% of the projected increase in fractures and 20% of the projected increase in lost QALYs could cost-effectively be avoided.

"There is a large gap between the number of people that are treated compared to the number that are eligible for treatment based on fracture risk, " stated IOF President John Kanis, Emeritus Professor in Human Metabolism and the Director of the WHO Collaborating Centre for Metabolic Bone Diseases at the University of Sheffield. "By decreasing that gap, and simultaneously improving adherence to treatment, we could significantly reduce the future human and health economic burden of fractures in Europe," he said.