PAM3: THE COST OF OSTEOPOROTIC FRACTURES IN THE UNITED KINGDOM

Abstract

BACKGROUND: The UK has more than 19 million people aged over 50, including about 9.4 million aged over 65. Demographic changes will lead to increases in the over-50 population of 10% and 25% by 2010 and 2020, respectively. There are already 3 million UK residents with osteoporosis, but the prevalence of osteoporosis increases with age, and the public health impact of osteoporosis will increase substantially over the next 20 years. OBJECTIVE: To predict fracture numbers and corresponding costs for men and women aged 50–99 years in the UK for the years 2000 to 2020. METHODS: A Markov model was designed to simulate the natural history of osteoporosis within the UK population. Inputs to the model included age/sex specific fracture incidence rates, published unit costs for different fracture types (hip, vertebral, forearm/wrist, other), age/sex specific mortality rates, and age/sex specific population totals. Total fracture numbers were adjusted using published site-specific attribution figures to identify the number that were a consequence of osteoporosis. Iteration techniques were employed across ages 50–99 in men and women, to generate the distribution of prevalence-based estimates of fractures and costs for the base year 2000. Osteoporosis costs and fracture numbers were then projected into future years by applying growth rates in age/sex specific population totals to these year 2000 estimates. RESULTS: In 2000 there were 190,000 osteoporosis-related fractures at a cost of £1.8 billion. Men accounted for 32,000 fractures and £330 million. By 2020, annual osteoporotic fracture numbers increased by over 21% to 230,000, with costs growing by 20% to over £2.1 billion. Cumulative totals for 2000–2010 were 2.2 million fractures and £20.3 billion. CONCLUSIONS: Osteoporotic fractures will have substantial and increasing impacts on UK health services unless highly effective preventative interventions achieve widespread use.