Osteoporotic fractures are very common and extremely expensive
- Worldwide, an osteoporotic fracture is estimated to occur every 3 seconds, which amounts to almost 25 000 fractures per day or 9 million per year.
- These fractures cost 32 billion EUR per year in Europe and 20 billion USD per year in the United States.
- In China, as the population ages, the 1.6 billion USD spent on hip fracture care in 2006 is set to rise to 12.5 billion USD by 2020 and 265 billion USD by 2050. Similar changes are projected across Asia, Latin America and the Middle East.
In the prevailing global economic climate, robust demonstration of cost-effectiveness is a prerequisite if new models of care are to be broadly implemented. In a growing number of countries throughout the world, Fracture Liaison Services (FLS) have been shown to be highly cost-effective and in some healthcare systems, cost-saving.
A Cost-Benefit Analysis
The Glasgow FLS analysed the cost effectiveness of its FLS over the last 8 years during which they have been providing secondary fracture care in Glasgow, Scotland. From the results, it is estimated that implementing an FLS for the entire UK, it will cost just 0.6% of the current annual hip fracture costs. In summary:
FLS cohort of 686 patients, compared with 'usual care' cohort of 193 patients:
- 18 fewer fractures
- 3 life years gained
- 22 QALYs gained
- 266 hospital bed-days saved
- cost saving of 312 000 GBP (US $497 498) from fractures avoided
||Usual care cohort
|cost of assessments
||98 000 GBP (US $156 208)
||14 000 GBP (US $22 316)
|cost of drugs
||292 000 GBP (US $465 451)
||85 000 GBP (US $135 535)
||21 000 GBP / 1000 patients (US $33 482)
Read more about the cost-savings at the Glasgow FLS.
Modelling of the costs of second fractures and the impact of effective FLS are available at national, regional and local levels below.
United States of America
- Prevalence and costs of osteoporotic patients with subsequent non-vertebral fractures in the US. Pike CT, Birnbaum HG, Schiller M, Swallow E, Burge RT, Edgell ET. Osteoporos Int. 2011 Oct;22(10):2611-2621. PubMed ID 21107532
- Cost burden of second fracture in the US health system. Song X, Shi N, Badamgarav E, Kallich J, Varker H, Lenhart G, Curtis JR. Bone. 2011 Apr 1;48(4):828-836. PubMed ID 21211578
Publications describing successful programmes from the following countries provide visitors with practical insights regarding how effective models of care have been established throughout the world.
Concord Repatriation General Hospital, Sydney, New South Wales
Edmonton Hospitals, Alberta
St. Michael’s Hospital, Toronto, Ontario
Glasgow University Hospitals, Scotland
United States of America
Geisinger Health System, Pennsylvania
Kaiser Permanente, Southern California