MASON, Ohio—The rate of osteoporosis-related fractures and the costs of caring for these fractures are expected to rise by almost 50% to more than three million fractures costing $25.3 billion by 2025, according to a new set of predictions published in the Journal of Bone and Mineral Research.¹ Nonwhites, including Hispanics, will be disproportionately affected by the increase, report researchers led by Russel Burge, PhD, of Proctor & Gamble & Personal Health in Mason, and the University of Cincinnati, both in Ohio.

But it's not too late to stop this trend, study authors write. "Our study results may assist health care policy-makers and providers in allocating scare resources for the disease in more cost-effective ways. By doing so, the cost and fracture trajectories predicted for the US population may be favorably altered," Dr. Burge writes.

2005 served as base year in study

In 2005, there were more than 2 million total fractures, costing nearly $17 billion; costs topped $19 million when prevalent fractures were included. Men accounted for 29% of these fractures and 25% of the costs. Total incident fractures by skeletal site were vertebral (27%), wrist (19%), hip (14%), pelvic (7%), and other (33%). Total costs by fracture type were vertebral (6%), hip (72%), wrist (3%), pelvic (5%), and other (14%), the study found. However, by 2025, the largest changes are predicted for pelvic fractures which will increase by 56% and the costs of treating these fractures will rise by 60%.

Total costs will grow most rapidly, increasing more than 87%, for people 65 to 74 years of age. This population will incur 70% of the increase in costs mostly from inpatient and long-term care, comprising 30% of the costs. By contrast, 13% of costs of fracture are incurred by outpatient care. There will be an increase in fractures of nearly 175% for Hispanic and other nonwhite subpopulations.

"The broad and asymmetric impact of disease across age, sex, race/ethnicity, and skeletal sites found in this study underscores the need for targeted disease intervention and treatment programs to populations with growing and unrecognized needs," the researchers write. "Osteoporosis prevention, treatment, and education efforts should address all skeletal sites, not just hip and vertebral, and appropriate attention is warranted for men and diverse race/ethnicity subgroups."

Study offers important snapshot of coming years

Ethel S. Siris, MD, the Madeline C. Stabile professor of clinical medicine and director of the Toni Stabile Osteoporosis Center at Columbia University Medical Center in New York City, told CIAOMed "this is a very important paper because it clarifies with very good data exactly how  many fractures are going to be occurring and exactly how expensive they are."

Moreover, "men certainly account for a substantial percent of fractures—29% of fractures and one-quarter of the cost," she said. "It also points out that there are fractures beyond spine and hip, and efforts at reducing fracture risks at these other sites have to be made. With great clarity, the new paper demonstrates the state of the situation."

Expected Osteoporosis and Fracture Costs by Race/Ethnicity: 2005-2025