A health economic analysis of osteoporotic fractures: who carries the burden?

SUMMARY: This is a cost-of-illness study of osteoporotic fractures in Denmark estimating the incremental societal cost associated with osteoporotic fractures, with both direct cost and productivity cost. This study includes cost regarding hospitals, general practices, the patients, the municipalities and regions. The total cost of osteoporotic fractures in Denmark was estimated at EUR 1.563 billion. PURPOSE: The aim of this study is to estimate the societal burden imposed by osteoporotic fractures in Denmark. In contrast to prior studies, this study will present a comprehensive model for the cost of osteoporotic fractures regarding hospitals, general practices, the municipalities, the regions and the patients. METHODS: This cost-of-illness study applied an incidence-based bottom-up approach from a societal perspective, including both direct costs and productivity costs. The study focused on incremental cost associated with osteoporotic fractures using a Markov model. Danish citizens ≥50 years with an osteoporotic fracture between 2001 and 2010 were studied. RESULTS: The total cost of osteoporotic fractures in Denmark was estimated to EUR 1.563 billion in 2011, at EUR 628 million and EUR 936 million for men and women, respectively. The most expensive fracture for both genders was first hip fracture. The municipalities carried the majority of the costs, with 55–57 % of incremental lifetime cost. CONCLUSIONS: This study showed that the incremental societal burden of osteoporotic fractures is an important health problem. Medical costs of the osteoporotic fractures were substantial cost for the health care sector, but were by far exceeded by the cost for the municipality in terms of social services and rehabilitation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11657-013-0126-3) contains supplementary material, which is available to authorized users.