Fragility fractures in Europe: burden, management and opportunities
Fragility fractures in Europe: burden, management and opportunities
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.
Disability-adjusted life years, Fracture costs, Fragility fracture, Quality-adjusted life years, Treatment gap
Borgström, F.
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Karlsson, L.
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Orsater, G.
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Norton, N.
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Halbout, Philippe
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Cooper, Cyrus
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Lorentzon, M.
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McCloskey, Eugene
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Harvey, Nicholas
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Kassim Javaid, M.
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Kanis, J A.
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1 December 2020
Borgström, F.
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Karlsson, L.
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Orsater, G.
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Norton, N.
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Halbout, Philippe
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Lorentzon, M.
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McCloskey, Eugene
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Harvey, Nicholas
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Kassim Javaid, M.
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Kanis, J A.
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Borgström, F., Karlsson, L., Orsater, G., Norton, N., Halbout, Philippe, Cooper, Cyrus, Lorentzon, M., McCloskey, Eugene, Harvey, Nicholas, Kassim Javaid, M. and Kanis, J A.
(2020)
Fragility fractures in Europe: burden, management and opportunities.
Archives of Osteoporosis, 15 (1), [59].
(doi:10.1007/s11657-020-0706-y).
Abstract
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.
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EU6 OP fragility fractures in Europe
- Accepted Manuscript
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Fragility fractures in Europe
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More information
Accepted/In Press date: 28 January 2020
e-pub ahead of print date: 30 April 2020
Published date: 1 December 2020
Additional Information:
Funding Information:
The report was made possible by the financial support from UCB to the International Osteoporosis Foundation.
Funding Information:
NC Harvey has received consultancy/lecture fees/honoraria/grant funding from Alliance for Better Bone Health, Amgen, MSD, Eli Lilly, Servier, Shire, UCB, Consilient Healthcare, Radius Health, Kyowa Kirin and Internis Pharma.
Funding Information:
JA Kanis reports grants from Amgen, Eli Lilly and Radius Health; consulting fees from Theramex. JAK is the architect of FRAX® but has no financial interest.
Publisher Copyright:
© 2020, The Author(s).
Keywords:
Disability-adjusted life years, Fracture costs, Fragility fracture, Quality-adjusted life years, Treatment gap
Identifiers
Local EPrints ID: 439556
URI: http://eprints.soton.ac.uk/id/eprint/439556
ISSN: 1862-3522
PURE UUID: 91ae1385-20fd-4e8c-bfac-d0f5a89c8c63
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Date deposited: 27 Apr 2020 16:30
Last modified: 18 Mar 2024 02:58
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Contributors
Author:
F. Borgström
Author:
L. Karlsson
Author:
G. Orsater
Author:
N. Norton
Author:
Philippe Halbout
Author:
M. Lorentzon
Author:
Eugene McCloskey
Author:
M. Kassim Javaid
Author:
J A. Kanis
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