Key findings:
- Poor bone health is common, costly, and preventable.
- By 2033, 7.7 million Australians aged 50 years and older are predicted to have osteoporosis and osteopenia – an increase of 23% from 2023 and 69% since 2012.
- In 2023, there was one fracture every 2.7 minutes in Australia. This will rapidly increase to 1 fracture every 30 seconds by 2033.
- The total cost of osteopenia and osteoporosis equated to $4.8 billion in 2023 and is estimated to climb to $8.3 billion per year by 2033.
- In 2023, the annual total fracture cost was $3.5 billion (91% direct costs) and is estimated to increase by 38% to be $4.9 billion by 2033.
- Hip fracture remains the costliest type of fracture, however fractures at other sites (wrist, spine, leg/arm) are more common.
- There is a need for early diagnosis of both men and women with osteoporosis or osteopenia, age 50 years and older.
Underestimated and under-prioritised bone health creates significant gap in preventing fractures
In 2023, an Australian study by Bliuc D and colleagues highlighted that in an older population (77-86 years old) with a higher risk of osteoporosis, only 17 percent of women and 7 percent of men were referred for a DXA scan, and 22 percent of women and 14 percent of men were prescribed osteoporosis medication after experiencing a fracture.
The study highlighted a significant gap in preventing, managing, and treating poor bone-health related fractures. Research lead on the “Osteoporosis and fractures in Australia” report, Shalika Bohingamu Mudiyanselage said for too long there has been a clinical focus on managing fractures, rather than preventing them by testing for underlying poor bone health, and treating accordingly.
“If someone over the age of 50 is getting treated for a fracture, it should be an opportunity to investigate their bone health such as osteoporosis and osteopenia,” she said.
Deakin team executes comprehensive data analysis
In response to this evidence gap – and as an update to the original report, “Osteoporosis Costing All Australians 2012-2023” – Deakin researchers devised a study to determine the annual burden of bone disease in 2023 and the future annual burden up until 2033. The objectives of the 2023-2033 analysis were:
- To estimate the prevalence and economic burden of minimal trauma fractures including routine management of osteoporosis and osteopenia in Australia in 2023, and
- to predict the prevalence and economic burden of minimal trauma fractures including routine management of osteoporosis and osteopenia in the next ten years from 2024 to 2033 including both new fractures and re-fractures.
“Our research involved extensive modelling, using existing data, to estimate what the actual prevalence of osteoporosis looked like in Australia, and its costs impacts,” explained research lead Dr Julie Abimanyi-Ochom.
“The fracture incidences were estimated based on the Geelong Osteoporosis Study. And we made forecasts for the prevalence of osteoporosis based on the Australian Bureau of Statistics population data, segmented by gender, age group (50-69 years and 70 years and older), and Bone Mineral Density (BMD) for those with osteoporosis, osteopenia, and without.”
The cost burden of fractures was determined by taking a bottom-up approach using data in the first osteoporosis study (2012-2023), while the total resource cost was calculated using the number of resources utilised by the population and the 2023 unit cost.
“We knew the economic burden of poor bone health (osteoporosis and osteopenia) looking forward would be high, but the numbers that were revealed in the study were startling,” said Abimanyi-Ochom.
Poor bone health is common, costly, and preventable
The study overwhelmingly found that the burden of osteoporosis and osteopenia is substantial, and will continue to increase with Australia’s ageing population.
According to Dr Abimanyi-Ochom, the results reinforce the urgent need for action from policy makers, healthcare professionals, and the community alike.
“Most of the burden of disease is attributed to the cost of treating fractures,” she said. “If we continue our current trajectory, the burden will continue to grow and add pressure on the healthcare system. There is an opportunity to prioritise the prevention of osteoporosis and osteopenia.”
“If poor bone health is diagnosed and the condition treated from an early stage, it can significantly lower the risk of fractures going forward, which in turn can improve the quality of life of the patient, and take further burden off the healthcare system.”
The report outlines several key recommendations, including:
- Encouraging the inclusion of bone mineral density checks in regular General Practitioner health check-ups for high-risk groups.
- Targeting both men and women aged 50 years and older with low bone mineral density in fracture prevention awareness
- Increasing funding towards public awareness and education programs on osteoporosis and osteopenia prevention
As a result of the report, policy makers are already considering a subsidy for bone medications for people aged 50 and over (until now, the subsidies have been for people over 70).
There has also been a shift in clinical focus from fracture management to fracture prevention.
“At the moment, the priority in clinical practices is focusing on managing fractures,” explained Dr. Abimanyi-Ochom. “New General Practice Guidelines are emphasising poor bone health prevention.”
Mudiyanselage said the report’s longer-term impacts are still to be seen.
“The report has recently been launched at Parliament House Canberra in the lead-up to World Osteoporosis Day 2024,” she said. “If the recommendations are considered, we expect there would be a significant reduction in healthcare costs over the next ten years, as well as an improvement in the quality of life for people with poor bone health.
“At the launch of the report, we heard a testimony from a patient which highlighted the missed opportunities for her in the healthcare system as it stands. It took more than 10 years for her to get a diagnosis of osteoporosis and the relevant treatments.”
“She had multiple fractures over this time and her height was reduced by 6cm. She now has to live with the pain, and she explained in her testimony how her sleep has been affected—that she can’t sleep in certain positions anymore. These are the kinds of stories we will hear less of if our recommendation for prevention is prioritised.”
Read the full report Osteoporosis and fractures in Australia. A burden of disease analysis, 2023 to 2033
Project title: Osteoporosis and fractures in Australia. A burden of disease analysis 2023-2033
Time period: 2023-2024
Research leads: Dr Julie Abimanyi-Ochom, Prof Jennifer J. Watts, Shalika Bohingamu Mudiyanselage, Dr Kidane Gebremariam
Funding: Healthy Bones Australia, $97,000
Partners and supporters: Healthy Bones Australia
References: Bohingamu Mudiyanselage S , Watts JJ, Gebremariam K, Abimanyi-Ochom J. Osteoporosis and fractures in Australia. A burden of disease analysis, 2023 to 2033.: Healthy Bones Australia; 2024. Report link: https://healthybonesaustralia.org.au/wp-content/uploads/2024/10/bod-2024-digital-isbn-29-10-24.pdf
