Epidemiology and Economic Burden of Osteoporosis in Italy

This report describes epidemiology, burden, and treatment of osteoporosis in Italy. 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 Italy, 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 Italy 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 465,000 new fragility fractures were sustained in Italy, comprising 91,000 hip fractures, 71,000 clinical vertebral fractures, 72,000 forearm fractures and 232,000 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)7,032 million for the same year. Incident fractures represented 61 % of this cost, long-term fracture care 34 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 171,300 quality-adjusted life years (QALYs) lost during 2010. When accounting for the demographic projections for 2025, the number of incident fractures was estimated at 598,000 in 2025, representing an increase of 132,000 fractures. Hip, clinical vertebral (spine), forearm and other fractures were estimated to increase by 27,900, 18,800, 15,400 and 70,300, respectively. The burden of fractures in Italy in 2025 was estimated to increase by 23 % to (sic)8,644 million. Though the uptake of osteoporosis treatments increased from 2001, the proportion of patients aged 50 or above who received treatment remained at very low levels in the past few years. The majority 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 aging populations, the use of pharmacological prevention of osteoporosis is significantly less than optimal, suggesting that a change in healthcare policy concerning the disease is warranted.