Social Impact of Osteoporotic Fractures: Early Diagnosis and Possible Therapies

Social Impact of Osteoporotic Fractures: Early Diagnosis and Possible Therapies

Maurizio Muratore (O.U. of Rheumatology, “Galateo” Hospital, San Cesario di Lecce, ASL-LE, Lecce, Italy), Francesco Conversano (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Maria Daniela Renna (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Paola Pisani (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Valeria Villani (Echolight S.r.l., Lecce, Italy) and Sergio Casciaro (National Research Council, Institute of Clinical Physiology, Lecce, Italy)
DOI: 10.4018/IJMTIE.2014040104

Abstract

Osteoporosis affects about 200 million subjects in the world and is responsible for 8.9 million fractures each year. The frequency of osteoporotic fractures is rising in many countries, due to the increased longevity of the population. In Europe, the annual cost of all osteoporotic fractures has been estimated to be 30 billion of Euros. In this paper, after an overview of the socioeconomic impact of osteoporosis in the world and in Italy, with particular focus on Apulia region, the most important techniques used to assess the fracture risk are briefly described. Moreover, the most commonly used pharmacological agents for the treatment of osteoporosis are reported. The aim of this review is to analyze the main factors causing the huge impact of osteoporosis on healthcare system, in terms of diagnosis and therapies, and to illustrate recent advances for treatment and prevention of this “silent disease”.
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Costs Of Osteoporotic Fractures

WHO considers osteoporosis to be second only to cardiovascular diseases as a critical health problem (Kanis et al., 1997). The disability due to osteoporosis is comparable or greater than that caused by cancers and by a variety of chronic non-communicable diseases, such as rheumatoid arthritis, asthma and high blood pressure-related heart disease (Johnell and Kanis, 2006).

Osteoporotic fractures are a major contributor to medical care costs in many countries of the world (Table 1). The total annual costs of osteoporosis exceed, for instance, those for various brain disorders (Ettinger et al., 1992). In the United States, the medical cost of osteoporosis and related fractures is estimated at 20 billion of dollars per year (Cummings and Melton, 2002) and the prediction in dependence of annual rise in age-adjusted incidence of osteoporotic fractures is estimated at 50 billion of dollars in 2050. China spent around 1.5 billion of dollars treating hip fracture in 2006. It is estimated that this will rise to 12.5 billion of dollars in 2020 and to more than 26 billion of dollars by 2050 (Luo and Xu, 2005).

Table 1.
Costs related to osteoporotic fractures in the world. (Data from Brandi and Piscitelli, 2013)
CountryAnnual expenditure due to hip fracture
(M Euros)
USA2,900
Canada300
Argentina140
Brazil1,400
Mexico120
China1,200
Japan1,120
Australia180

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