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Fragility fractures in Europe: burden, management and opportunities

Fragility fractures in Europe: burden, management and opportunities
Fragility fractures in Europe: burden, management and opportunities
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 1,000 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
10.1007%2Fs11657-020-0706-y
1862-3522
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
ce487fb4-d360-4aac-9d17-9466d6cba145
Kassim Javaid, M.
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Kanis, J A.
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Borgström, F.
38075d38-f1fd-4a6e-9743-f4b6165c9d89
Karlsson, L.
ca2a45bc-fa75-402c-8b1d-57eb317f4a8f
Orsater, G.
da5d3e08-0880-40f9-ac00-fa864eb4e643
Norton, N.
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Halbout, Philippe
a6bac6c8-e463-4c0d-bb75-389ad2b0b945
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Lorentzon, M.
11692e10-5916-4bb5-86c5-3ff9ccd77af6
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
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%2Fs11657-020-0706-y).

Record type: Article

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 1,000 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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More information

Accepted/In Press date: 28 January 2020
e-pub ahead of print date: 30 April 2020
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
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 27 Apr 2020 16:30
Last modified: 26 Nov 2021 02:48

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Contributors

Author: F. Borgström
Author: L. Karlsson
Author: G. Orsater
Author: N. Norton
Author: Philippe Halbout
Author: Cyrus Cooper ORCID iD
Author: M. Lorentzon
Author: Eugene McCloskey
Author: Nicholas Harvey ORCID iD
Author: M. Kassim Javaid
Author: J A. Kanis

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