What is the Current Situation of Osteoporosis?

By 2025, it is estimated that 13.5 million fragility fractures, or broken bones after a fall, will occur worldwide each year. 500 million people will be living with osteoporosis, a long-term disease which weakens bones and leaves people at risk of a fragility fracture [1].

Up to one in two women and one in five men aged 50 years or over will experience a fragility fracture in their lifetime causing an estimated 8.9 million fragility fractures every year [2]

osteoporosis estimation

Pain and limited mobility following a fragility fracture mean people are often at risk of losing their independence. In a study, 80% of women at high risk of developing a hip fracture stated that they would rather die than experience the loss of independence attributed to a hip fracture [3]. The experience of a fracture can cause anxiety due to a fear of falling, self-image issues and the limitations associated with carrying out day-to-day activities [4].

Alarmingly, most people do not receive risk-reducing treatment after a first fracture. This significantly increases the likelihood of sustaining a subsequent fracture. An estimated 60-80% of women with osteoporosis do not receive treatment within one year of a fracture [5].

fragility cost

Fragility Fractures Represent a Significant Cost for Health Systems

Fragility fractures cost global healthcare systems $400 billion [1] and account for around 3% of healthcare costs. By 2050, the costs of fragility fractures are set to double [6]. This financial burden is higher than for many other noncommunicable diseases. For example, the EU’s direct healthcare costs due to osteoporosis were €37.4 billion in 2015, while other costs in 2015 were estimated at €20 billion for stroke and €19 billion for coronary heart disease, significantly higher than for many other leading chronic diseases [1].

cost burden

Globally, the burden of years lived in poor health due to osteoporosis is greater than that caused by cancers (except for lung cancer) and is comparable to or greater than that of many other non-communicable diseases, such as asthma and hypertension-related heart disease [7]. Hip fractures have been found to at least double the risk of death for both men and women [8,9].

What needs to be done

For too long, the burden represented by osteoporosis and fragility fractures have been underestimated in health policy. Even policies, strategies and programs that focus on healthy ageing and women’s health often ignore the impact of osteoporosis and bone fragility. This has left millions of people – mostly women – without access to the care and support they need to live full, independent lives.

Capture the Fracture® (CTF) therefore aims to play a role in widening societal and political awareness for progress and change. Our strategy is to encourage policy makers and government health officials to prioritize bone health and Post-Fracture Care (PFC) Coordination Programs, such as Fracture Liaison Services (FLS) at international, regional and national levels.

CTF’s best-practice framework supports the need for PFC service implementation by defining the quality standards to prevent subsequent fractures. The CTF program has a diverse set of tools that provides essential resources and documentation to drive quality improvement in PFC services. CTF also offers a mentorship program to support the development and sustainability of PFC services at the local level.

It is crucial that policymakers support the development of clear national guidance on identifying subsequent fragility fractures and treating osteoporosis, which is informed by national scientific consensus. In countries which have applied this approach the rates of osteoporosis and falls assessments are over 90%. In those which have not followed this approach, the rates are below 4% [10].

Figure 1

Rates of osteoporosis and falls assessment across the world

Countries with clear national guidances on identification and treatment

Countries without clear national guidances on identification and treatment

Rates of osteoporosis and falls assessment across the world

CTF Partnership Roadmap for Policy Shaping

We have developed an international resource, Capture the Fracture® Partnership - Guidance for Policy Shaping, that provides four simple building blocks of an effective policy response against osteoporosis.













1. Hernlund E, Svedbom A, Ivergard M et al. (2013) 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). Arch Osteoporos 8:136. doi:10.1007/s11657-013-0136-1

2. Osteoporosis prevention, diagnosis, and therapy (2001). Jama 285 (6):785-795. doi:10.1001/jama.285.6.785

3. Cameron ID, Dyer SM, Panagoda CE et al. (2018) Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 9 (9):Cd005465. doi:10.1002/14651858.CD005465.pub4

4. Ross PD (1997) Clinical consequences of vertebral fractures. Am J Med 103 (2a):30S-42S; discussion 42S-43S. doi:10.1016/s0002-9343(97)90025-5

5. Broken Bones, Broken Lives: a roadmoap to solve the fragility fracture crisis in Europe (2018). International Osteoporosis Foundation 4. RheumaMap: A Research Roadmap to transform the lives of people with Rheumatic and Musculoskeletal Diseases (2019). European League Against Rheumatism Taskforce

6. Reginster JY, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38 (2 Suppl 1):S4-9. doi:10.1016/j.bone.2005.11.024

7. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17 (12):1726-1733. doi:10.1007/s00198-006-0172-4

8. Katsoulis M, Benetou V, Karapetyan T et al. (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med 281 (3):300-310. doi:10.1111/joim.12586

9. Haentjens P, Magaziner J, Colón-Emeric CS et al. (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152 (6):380-390. doi:10.7326/0003-4819-152-6-201003160-00008

10. Tian M, Gong X, Rath S et al. (2016) Management of hip fractures in older people in Beijing: a retrospective audit and comparison with evidence-based guidelines and practice in the UK. Osteoporos Int 27 (2):677-681. doi:10.1007/s00198-015-3261-4