Abstract
This report describes epidemiology, burden, and treatment of osteoporosis in Belgium.
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 Belgium, 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 Belgium were 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 80,000 new fragility fractures were sustained in Belgium, comprising 15,000 hip fractures, 12,000 vertebral fractures, 12,000 forearm fractures and 41,000 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)606 million for the same year. Incident fractures represented 69 % of this cost, long-term fracture care 26 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 26,800 quality-adjusted life years (QALYs) lost during 2010. When accounting for the demographic projections for 2025, the number of incident fractures was estimated at 99,000 in 2025, representing an increase of 19,000 fractures. Hip, clinical spine, forearm and other fractures was estimated to increase by 3,900, 2,900, 2,300 and 10,300, respectively. The burden of fractures in Belgium in 2025 was estimated to increase by 21 % to (sci)733 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 proportion 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.