China Wrestling With Economic Burden of Osteoporosis-Related Fractures

Osteoporosis-related fractures have caused a substantial and increasing economic burden to the Chinese health care system, according to study findings presented at the International Osteoporosis Foundation Regional Asia-Pacific Osteoporosis meeting in Taipei.

Using a state-transition microsimulation model, researchers considered hip, wrist and vertebral fractures and five disease states—no history of fracture event, history of hip fracture, history of vertebral fracture, history of wrist fracture and dead—for the Chinese population between the ages of 50 and 99 from 2010 to 2050.

The annual fracture incidence and fracture-related cost was simulated using one-year cycle from the Chinese health care system perspective. By multiplying age- and sex-specific annual fracture risk and costs of fracture by corresponding population totals in 100 unique patient populations, incidences and annual costs of fractures were estimated for 2010. The researchers performed projections for 2011 to 2050 by multiplying the 2010 incidence and costs of fracture by the respective annual population estimations.

Study results showed in 2010, more than 2.3 million osteoporosis-related hip, clinical vertebral and wrist fractures were estimated to occur among individuals ages 50 years and older, costing the Chinese health care system approximately $9.61 billion. By the year 2035, the fracture incidence and related costs were estimated to double and are expected to increase to 5.93 million by 2050, resulting in costs of approximately $25.58 billion.

According to the researchers, women sustained approximately three times more fractures vs. males and accounted for 73 percent of the total costs.

“The results are critically important to the health care policy makers in China, as we have shown that osteoporosis had a substantial and growing disease and financial burden to the Chinese health care system,” study author, Lei Si, MSc, Ph.D candidate, of the Menzies Institute for Medical Research, University of Tasmania. “Osteoporosis has been listed as one of the National Health Priorities since 2011 in China. The good news is that more money will be injected into osteoporotic fracture prevention programs in the future, but the next question is how do we get value for this money?”

The scarcity of health resources means there must be programs available that represent good value for the money, according to Si.

“We need to undertake most cost-effective studies to identify the osteoporotic fracture preventions with the most health gain and least money spent,” Si said.