Health Economics

Osteoporotic fractures are very common and extremely expensive

  • Worldwide, an osteoporotic fracture is estimated to occur every 3 seconds, which amounts to almost 25 000 fractures per day or 9 million per year.
  • These fractures cost 32 billion EUR per year in Europe and 20 billion USD per year in the United States.
  • In China, as the population ages, the 1.6 billion USD spent on hip fracture care in 2006 is set to rise to 12.5 billion USD by 2020 and 265 billion USD by 2050. Similar changes are projected across Asia, Latin America and the Middle East.

In the prevailing global economic climate, robust demonstration of cost-effectiveness is a prerequisite if new models of care are to be broadly implemented. In a growing number of countries throughout the world, Fracture Liaison Services (FLS) have been shown to be highly cost-effective and in some healthcare systems, cost-saving.

A Cost-Benefit Analysis

The Glasgow FLS analysed the cost effectiveness of its FLS over the last 8 years during which they have been providing secondary fracture care in Glasgow, Scotland. From the results, it is estimated that implementing an FLS for the entire UK, it will cost just 0.6% of the current annual hip fracture costs. In summary:

FLS cohort of 686 patients, compared with 'usual care' cohort of 193 patients:

  • 18 fewer fractures
  • 3 life years gained
  • 22 QALYs gained
  • 266 hospital bed-days saved
  • cost saving of 312 000 GBP (US $497 498) from fractures avoided
  FLS cohort Usual care cohort
cost of assessments 98 000 GBP (US $156 208) 14 000 GBP (US $22 316)
cost of drugs 292 000 GBP (US $465 451) 85 000 GBP (US $135 535)
overall saving 21 000 GBP / 1000 patients (US $33 482)  

Read more about the cost-savings at the Glasgow FLS.

Modelling of the costs of second fractures and the impact of effective FLS are available at national, regional and local levels below.


United Kingdom

United States of America

Publications describing successful programmes from the following countries provide visitors with practical insights regarding how effective models of care have been established throughout the world.


Concord Repatriation General Hospital, Sydney, New South Wales


Edmonton Hospitals, Alberta

St. Michael’s Hospital, Toronto, Ontario

United Kingdom

Glasgow University Hospitals, Scotland

United States of America

Geisinger Health System, Pennsylvania

Kaiser Permanente, Southern California