Osteoporosis is a risk factor for people with RA and JIA30 October 2018 Bath, London, 19, October 2018 New report released today by the International Osteoporosis Foundation (IOF) and supported by the National Osteoporosis Society (NOS) has highlighted the hidden, but very real, burden of fragility fractures. The results, which form part of a wider European report delivered by the IOF, estimate that the NHS faces an annual burden of £4.5 billion in healthcare costs associated with fragility fractures, a sum which is threatening to cripple the British healthcare system by stealth.1 The UK’s population is at its largest ever; exceeding 66 million, with the proportion of people aged 65 and over at 18 per cent.2 This ageing population is set to continually rise, to an estimated 24 per cent in 2047,2 meaning the prevalence of chronic conditions, such as osteoporosis, will further increase, leading to an exponential rise in the incidence of fragility fractures as a result of osteoporosis. NOS Clinical Director Alison Doyle stated: “There is significant impact on people’s lives. With over half a million new broken bones occurring in the UK in 2017, fragility fractures are a major obstacle to healthy ageing which impact on the independence and quality of life of 3.5 million women and men living with osteoporosis in the UK.1 Without a commitment to change, people will continue to break their bones. This number is expected to increase by a further 26 per cent by 2030. As well as the individual personal cost there is the associated cost impact escalating further, estimated to hit £5.9 billion in the same time period.1 The burden of fragility fractures in the UK already exceeds that for chronic obstructive pulmonary disease (COPD) and ischaemic stroke.3 Our beneficiaries tell us what is important to them, which is living well and embracing older age without the fear of further fractures. In addition to the cost burden, the physical and emotional impact must not be overlooked. Professor John Kanis, IOF Honorary President, explains “Worldwide, fragility fractures affect one in three women and one in five men aged 50 or above.4 They can result in significant impairment, often making daily activities such as eating, dressing, washing or shopping difficult. For those that suffer a hip fracture, there is a 40 per cent chance that they will not be able to walk independently. The physical and psychological impact is huge.” he report, “Broken bones, broken lives: A roadmap to solve the fragility fracture crisis in the United Kingdom”, provides evidence that despite the availability of effective preventative therapies and management approaches for fragility fractures, 49% of women over 50 years of age in the UK are not receiving treatment following a hip fracture.1 After a fragility fracture, women are five times more likely to experience a second fracture within the next year,1,5 yet less than half the women who sustain a hip fracture at or after the age of 50 within the UK go on to receive treatment for osteoporosis in the following year.1,4 The social and economic impacts of fragility fractures highlight the need and urgency to implement best in class models of care. Coordinated care models such as the Fracture Liaison Service (FLS) have shown to deliver improved patient outcomes and cost-saving treatments in an effective manner. In the UK, FLS provision cover is estimated to prevent 5,686 subsequent fragility fractures every year and achieve net cost savings of £1.2 million a year.6 Besides FLSs, additional solutions could help prevent many fragility fractures. Influencing through interactions with policy makers and commissioners will play a crucial role in funding diagnostic services and cost-effective interventions such as pharmacological treatment, falls prevention programs and coordinated care models, as well as enforcing necessary standards for healthcare professionals and institutions. “Broken Bones do break lives. This report is a call to action for policy maker and commissioners to prioritise activities that can make a difference for people with fragility fractures, with focus upon: care standards, local service improvement, strengthening of national policy and raising awareness to change behaviour to enable effective management of people with fragility fractures,” added NOS. Professor Cyrus Cooper, IOF President, comments: “With the rising burden of fragility fractures imposing on the NHS, it is our ambition that these reports can support stakeholders in taking the necessary actions to cut associated costs and stop broken bones from breaking lives. As the economic stranglehold of fragility fractures tightens on healthcare systems, now is the time to take action and up-scale our response to this silent threat. We call on NHS England and the commissioners to accelerate this process by prioritising care standards and funding to support the effective management of fragility fractures, thus avoiding escalation of related costs. and prevent fractures and unnecessary admissions to hospital.” Cooper concludes: “At times of constraints on healthcare spending, we can no longer afford to ignore the prevention and management of fragility fractures.” Alongside the UK report, detailed country reports are available for France, Germany, Italy, Spain, and Sweden. An additional report summarising the wider impact of fragility fractures to healthcare systems across these six European countries is also available. Notes to editors: Osteoporosis is a condition where bones weaken at a faster rate than normal; making them fragile and more likely to break.7 Even the slightest bump or fall can result in a broken bone (referred to as a ‘fragility fracture’).7,8 After experiencing the first fracture, the likelihood of incurring another greatly increases. Worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience a fragility fracture due to osteoporosis.9 About IOF The International Osteoporosis Foundation (IOF) is the world’s largest nongovernmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF members, including leading scientific experts and 240 patient, medical and research societies worldwide, work together to make fracture prevention and healthy mobility a global health care priority. www.iofbonehealth.org About NOS The NOS is the only UK charity dedicated to ending the pain and suffering caused by osteoporosis and believes in better bone health for everybody. It does this by caring for and supporting people living with the condition, delivering an extensive range of professional development for healthcare professionals, promoting good bone health to prevent osteoporosis and funding research to help those affected. The NOS has firmly established its position as the leading national patient group for people with osteoporosis. Through its large member base, NOS has led effective bone health advocacy campaigns and is a driving force in the promotion and development of Fracture Liaison Services across the UK. References 1 International Osteoporosis Foundation. Broken Bones, Broken Lives: A roadmap to solve the fragility fracture crisis in the United Kingdom. Last accessed September 2018 2 Office of National Statistics. Overview of the UK population: July 2017. Last accessed September 2018. 3 Institute for Health Metrics and Evaluation (IHME) (2016) GBD Compare Data Visualization. Last accessed August 2018.4 Data on file. 2018. Fragility Fractures in the UK. Burden, management and opportunities: EU6 Summary Final Report 2018-06-26. 5 Johansson H, Siggeirsdottir K, Harvey NC, et al. Imminent risk of fracture after fracture. Osteoporos Int 2017;28:775–80. 6 Wu CH, Tu ST, Chang YF, et al. Fracture liaison services improve outcomes of patients with osteoporosis related fractures: A systematic literature review and meta-analysis. Bone 2018;111:92–100. 7 Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jönsson B. Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2011;6:59-155. doi: 10.1007/s11657-011-0060-1. 8 International Osteoporosis Foundation. Capture The Fracture – A global campaign to break the fragility fracture cycle (October 2012). Last accessed September 2018. 9 International Osteoporosis Foundation. Osteoporosis in the European Union in 2008: Ten years of progress and ongoing challenges (October 2008). Last accessed September 2018.