Fragility fractures in Europe: burden, management and opportunities

[en] Summary: 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. © 2020, The Author(s).

Disciplines :

Public health, health care sciences & services

Author, co-author :

Borgström, F.; Medical Management Centre, Department of Learning Informatics, Management and Ethics, Karolinska Institute, Solna, Sweden, Quantify Research, Stockholm, Sweden

Karlsson, L.; Quantify Research, Stockholm, Sweden

Ortsäter, G.; Quantify Research, Stockholm, Sweden

Norton, N.; Quantify Research, Stockholm, Sweden

Halbout, P.; International Osteoporosis Foundation, Nyon, Switzerland

Cooper, C.; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom, National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom

Lorentzon, M.; Mary MacKillop Health Institute, Catholic University of Australia, Melbourne, Australia, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

McCloskey, E. V.; Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, United Kingdom, MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom

Harvey, N. C.; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom

Javaid, M. K.; National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom

More authors (4 more)

Title :

Fragility fractures in Europe: burden, management and opportunities

Publication date :

2020

Journal title :

Archives of Osteoporosis

ISSN :

1862-3522

eISSN :

1862-3514

Publisher :

Springer

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

IOFUCB - International Osteoporosis Foundation
UCB UK
Lilly and Company

Available on ORBi :

since 30 July 2020

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