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For Your Patients: The Many and Increasing High Costs of Osteoporosis

— The economic toll is both direct and indirect, to patients as well as the healthcare system overall

MedpageToday
Illustration of a dollar sign and red arrow pointing upwards over a bone with osteoporosis
Key Points

Like other chronic conditions of older age such as heart disease, osteoporosis takes a large toll on the country's healthcare resources. This bone condition costs billions each year for treatment medications and in particular, for hospitalizations and surgeries after fractures.

Think of an osteoporosis-related fragility fracture as a "heart attack of the bone," requiring similar costly follow-up and preventive treatment in the years following the first fracture.

Currently, about 10 million Americans have osteoporosis, 44 million have risky low bone density, and more than half of all adults over age 50 are at risk of breaking a bone.

And as the U.S. population keeps getting older demographically, those costs are only going to rise.

Therefore it's important that all women have bone density screening at age 65 and all men at age 70 and start bone density treatment if necessary -- before a costly osteoporotic fracture occurs -- costly in terms of healthcare use and often costly for the patient.

Fast Facts

  • In the U.S. osteoporosis is responsible for two million broken bones and $19 billion in related costs every year.
  • By 2025, osteoporosis is predicted to cause approximately three million fractures and account for more than $25 billion in annual costs.
  • In the year after a fracture, direct healthcare costs totaled more than $30,000, according to one study -- with an average of $3,000 paid out of pocket by the patient.
  • Following a first fracture, refracture occurs within 12 months in nearly 7% of patients, and this rate rises to almost 30% after 4 years. Costs increase incrementally with each subsequent fracture.
  • In the first year after a hip fracture there's an increased risk of death for more than 20% of patients, with a higher rate in men, owing to their generally older age and poorer health at the time of fracture.

Patients' Costs

Apart from medication co-pays, uncovered medical costs, and post-fracture rehabilitation expenses, osteoporosis accounts for a significant amount of lost productivity, missed work, reduced income, loss of independence, and impact on mobility, including for driving and daily routines and activity. Some patients may be forced into early retirement after debilitating fractures.

Other costs may include:

  • Relocating to a one-story dwelling to avoid falls on stairs.
  • Fall-proofing the home with sturdy railings and grab bars, non-slip flooring, and brighter lighting.
  • Upgrading eyeglasses and improving footwear for greater stability and minimal risk of slipping.
  • Purchasing assistive walking devices such as canes, hiking poles, and walkers, and for some patients, a scooter or wheelchair.
  • Psychological counseling to overcome the fear of resuming daily activities and walking after fracture.
  • Increased home help as well as more delivery and transportation costs, especially when outdoor conditions are slippery.
  • In cases of disabling hip fracture, some patients may need to enter a nursing home.

All these expenses underscore the need to get screened, diagnosed, and treated before the disease progresses and fracture results.

Ask your doctor for information about where you might get help to offset some of these expenses.

Read previous installments in this series:

For Your Patients: Osteoporosis -- the 'Silent Thief'

For Your Patients: What to Know About Osteoporosis Diagnosis and Treatment

For Your Patients: Osteoporosis and Fractures

For Your Patients: Men Get Osteoporosis, Too

For Your Patients: Medical Conditions That Raise Your Risk of Osteoporosis

For Your Patients: Talking to Your Doctor About Osteoporosis

For Your Patients: What to Know About Osteoporosis and Oral/Dental Health

For Your Patients: Exercising with Osteoporosis

For Your Patients: Osteoporosis and Nutrition

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.

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    Diana Swift is a freelance medical journalist based in Toronto.