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Osteoporosis in the European Union: medical management, epidemiology and economic burden : A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA)

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      This report describes the epidemiology, burden, and treatment of osteoporosis in the 27 countries of the European Union (EU27).


      Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures which represent the main clinical consequence of the disease. Fragility fractures are associated with substantial pain and suffering, disability and even death for affected patients and substantial costs to society. The aim of this report was to characterize the burden of osteoporosis in the EU27 in 2010 and beyond.


      The literature on fracture incidence and costs of fractures in the EU27 was reviewed and incorporated into a model estimating the clinical and economic burden of osteoporotic fractures in 2010.


      Twenty-two million women and 5.5 million men were estimated to have osteoporosis; and 3.5 million new fragility fractures were sustained, comprising 610,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures). The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Incident fractures represented 66 % of this cost, long-term fracture care 29 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining.


      In spite of the high social and economic cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by the aging populations, the use of pharmacological interventions to prevent fractures has decreased in recent years, suggesting that a change in healthcare policy is warranted.

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      Author and article information

      [ ]OptumInsight, Stockholm, Sweden
      [ ]Department of Medicine, Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
      [ ]MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
      [ ]NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK
      [ ]International Osteoporosis Foundation, Nyon, Switzerland
      [ ]Academic Unit of Bone Metabolism, Northern General Hospital, University of Sheffield, Sheffield, UK
      [ ]WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
      [ ]Stockholm School of Economics, Stockholm, Sweden
      [ ]WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX UK
      +44-114-2851109 , +44-114-2851813 ,
      Arch Osteoporos
      Arch Osteoporos
      Archives of Osteoporosis
      Springer London (London )
      11 October 2013
      11 October 2013
      : 8
      24113837 3880487 136 10.1007/s11657-013-0136-1
      © The Author(s) 2013

      Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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      © International Osteoporosis Foundation and National Osteoporosis Foundation 2013



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