Prevalence of Osteoporosis-Related Fractures is Alarmingly High

"Approximately 1.4 million Medicare FFS beneficiaries, or about 4% of the total, suffered over 1.6 million osteoporotic fractures in 2015. Applying the same rate of osteoporotic fractures to Medicare Advantage (MA) beneficiaries would add an additional 700,000 fractures (suffered by 600,000 beneficiaries), for a total of 2.3 million fractures suffered by all Medicare beneficiaries."

"79% of fractures among Medicare fee-for-service and Medicare Advantage beneficiaries affected women."

"Annual allowed medical costs to Medicare for beneficiaries in the 12-month period beginning with the new osteoporotic fracture were more than twice the costs incurred in the 12-month period prior to the fracture for the same beneficiaries. The incremental annual medical cost of a new osteoporotic fracture was over $21,800, which included only direct costs identifiable through an administrative medical claims database."

“Annual allowed medical costs to Medicare for beneficiaries in the 12-month period beginning with the new osteoporotic fracture were more than twice the costs incurred in the 12-month period prior to the fracture for the same beneficiaries. The incremental annual medical cost of a new osteoporotic fracture was over $21,800, which included only direct costs identifiable through an administrative medical claims database.”

“The incremental annual medical cost in the year following a new osteoporotic fracture increased substantially for skilled nursing facility services (+256%) as compared to the year prior to the fracture, which accounted for about 30% of the total incremental annual medical cost of $21,800. ”

“The estimated incremental medical cost to Medicare of a subsequent fracture over the 180-day period following a new osteoporotic fracture was over $20,700. ”

“Nearly one in five Medicare FFS beneficiaries died within 12 months following a new osteoporotic fracture. This accounted for approximately 260,000 deaths among Medicare FFS beneficiaries who suffered an osteoporotic fracture in 2015. Of these, about 164,000 were female and 96,000 were male. Beneficiaries with a hip fracture had the highest mortality; of Medicare FFS beneficiaries with a hip fracture, 30% died within 12 months of the fracture. An estimated 307,000 Medicare FFS beneficiaries suffered a subsequent fracture during a follow-up period that lasted up to two to three years and survived for at least 180 days after the subsequent fracture.”

"Preventing between 5% and 20% of subsequent fractures could have saved between $310 million (95% CI: $272 million to $358 million) and $1,230 million (95% CI: $1,076 million to $1,421 million) for the Medicare FFS program during a follow-up period that lasted up to two to three years after a new osteoporotic fracture, based on the historical incidence and treatment patterns of beneficiaries who had an osteoporotic fracture in 2015. This savings estimate includes the cost of performing BMD tests on an additional 10% to 50% of new osteoporotic fracture patients, but does not account for any increased costs of osteoporosis treatment or additional administrative costs of a secondary fracture prevention program."

$57 billion (estimate) cost associated with treating osteoporosis-related fractures in 2018. By 2040, projections show a spend of $95 billion or more.