Osteoporosis is as costly to society as cancer
A new study from the University of Southern Denmark shows that the disease costs Danish society 15 billion Danish kroner annually. Prevention could significantly reduce the economic burden.
Osteoporosis, also known as brittle bone disease, affects up to 700,000 Danes, but it is often only diagnosed after patients experience severe fractures.
A new study from DaCHE – the Danish Centre for Health Economics at the University of Southern Denmark (糖果派对), published in the journal Osteoporosis International, shows that the annual societal costs of osteoporosis in Denmark amount to more than 15 billion Danish kroner.
– Many will probably be surprised that osteoporosis is as costly as cancer when you look at the total costs, says Marie Kruse, Associate Professor of Health Economics at the University of Southern Denmark and one of the study’s authors.
– But osteoporosis affects many people and is often a lifelong disease requiring long-term treatment and care. That’s why the overall costs are so high.
Prevention is key
Marie Kruse points out that the disease is more expensive for society the later it is detected. She therefore believes that early detection makes good sense.
– Prevention can reduce the risk of severe fractures, decrease hospital admissions, and save society significant costs, says Marie Kruse.
The current study does not evaluate the effectiveness of treatments, but Marie Kruse believes that effective prevention of osteoporosis offers substantial benefits. Encouraging people over 50 to exercise more, quit smoking, and perhaps adopt healthier eating habits can lower their risk of developing the disease.
– For those who have already developed osteoporosis, prevention then focuses on avoiding fractures. Systematic fracture prevention programmes known as FLS (Fracture Liaison Services) already exist. They are not widely implemented in Denmark but have been proven cost-effective in identifying, diagnosing, and treating osteoporosis patients. A national implementation could ensure more patients are diagnosed early and receive preventive treatment, thereby reducing serious fractures and related costs.
The costs of osteoporosis
– We identified 300,000 patients with osteoporosis and fractures and tracked their interactions with the healthcare system for up to 20 years or until they turned 90. Additionally, we compared them with 300,000 other Danes without the disease, matched by age, gender, income, education, and other relevant factors, explains Marie Kruse.
Together with her research colleagues from 糖果派对, she analysed costs in both the primary and secondary healthcare sectors. This includes expenses for medication, GP visits, hospital visits and admissions, rehabilitation, home care, home nursing, and nursing homes. For those under 66, lost productivity was also considered.
The findings show that osteoporosis patients cost society an average of 23,000 Danish kroner more per year than those without the disease.
Total societal costs
The total annual cost of 15 billion Danish kroner was calculated by multiplying the individual costs by the Danish Health Authority’s estimate of how many Danes have osteoporosis. This figure is based on data for the entire population of people with the disease in Denmark.
– The costs are high because osteoporosis affects many people and is expensive to treat, especially among elderly patients. Moreover, it is a chronic disease that patients live with for many years, says Marie Kruse.
Patients who are diagnosed late, after suffering a severe fracture, are the most expensive to treat.
The economic costs
- Annual productivity loss per patient under 66: approx. 29,000 DKK (3,883 EUR).
- Highest costs: Hip fractures (1.85 times higher than the control group) and spinal fractures (1.62 times higher).
- Lowest costs: Wrist fractures (1.39 times higher than the control group).
Costs increase with age
The older the patients get, the more expensive the treatment becomes. Patients diagnosed after a severe hip fracture are particularly costly for society. Costs generally increase with age, but the increase is greater for those with osteoporosis compared to those without. This means that the additional costs related to osteoporosis also rise with age, says Marie Kruse.The study also shows that patients under 66 with osteoporosis cost society approximately 29,000 DKK annually in lost productivity, as many leave the labour market earlier than they otherwise would.
Which fractures caused by osteoporosis are the most expensive?
According to the study, patients diagnosed late due to a severe hip fracture are the most expensive to treat.
Hip fractures are associated with the highest costs, followed by spinal fractures.
The lowest costs are among patients diagnosed early with less severe fractures, such as wrist fractures, and who subsequently receive preventive treatment, as well as cases detected through screening.
These patients are often younger and recover more quickly.
About the study
The study was conducted by Liza Sopina, Marie Kruse, and Benedicte Torp Ladefoged from DaCHE – the Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Mette Friberg Hitz from Zealand University Hospital, Lau Caspar Thygesen from the National Institute of Public Health, University of Southern Denmark, and Bente Langdahl from Aarhus University Hospital.
The study used a difference-in-difference method with individual matching to separate costs related to osteoporosis from other factors. Data was collected over a 21-year period and covers the entire population of individuals with osteoporosis born between 1930 and 1950 in Denmark.
The study was supported by the Osteoporosis Society and the Ellab Foundation.
Read the scientific article: (link)
Meet the researcher
Marie Kruse is an Associate Professor of Health Economics and a data and analysis specialist at DaCHE 鈥� the Danish Centre for Health Economics, Department of Public Health.