Epidemiology and Economic Burden of Osteoporosis in Portugal

This report describes epidemiology, burden, and treatment of osteoporosis in Portugal. Introduction Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risks 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 the affected patients and substantial costs to society. The aim of this study is to describe the epidemiology and economic burden of fragility fractures as a consequence of osteoporosis in Portugal, as a further detailed addition to the report for the entire European Union (EU27): Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden. Methods 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. Furthermore, data on sales of osteoporosis treatments and the population at high risk were used to estimate treatment uptake and treatment gap. Results It was estimated that approximately 52,000 new fragility fractures were sustained in Portugal, comprising 10,000 hip fractures, 8,000 vertebral fractures, 8,000 forearm fractures and 26,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures) in 2010. The economic burden of incident and previous fragility fractures was estimated at (sic) 577 million for the same year. Incident fractures represented 51 % of this cost, long-term fracture care 46 % and pharmacological prevention 3 %. Previous and incident fractures also accounted for 17,900 quality-adjusted life years (QALYs) lost during 2010. When accounting for the demographic projections for 2025, the number of incident fractures was estimated at 69,000 in 2025, representing an increase of 17,000 fractures. Hip, clinical spine (vertebral), forearm and other fractures were estimated to increase by 3,700, 2,400, 2,000 and 9,100, respectively. The burden of fractures in Portugal in 2025 was estimated to increase by 24 % to (sic) 717 million. Though the uptake of osteoporosis treatments increased from 2001, the proportion of patients aged 50 or above who received treatment declined in the past few years. A substantial minority of women at high fracture risk did not receive active treatment. Conclusions In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by an aging population, the use of pharmacological prevention of osteoporosis is significantly less than optimal, suggesting that a change in healthcare policy concerning the disease is warranted.