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PREVENTING
OSTEOPOROSIS IN
THE EU
EVENT REPORT | 2020 - 2021
https://eurac.tv/9RQX
With the support of
PREVENTING
OSTEOPOROSIS IN
THE EU
EVENT REPORT Osteoporosis is a chronic condition in which bones be-
come weak and brittle, leading to fractures and breaks
https://eurac.tv/9RQX
which often carry life-debilitating consequences.
As well as causing considerable mental and psycholog-
ical distress, they also severely impair people’s abilities
to participate in normal life and their ability to work.
In the EU alone, it’s estimated that 22 million women
and 5.5 million men suffer from the bone condition, re-
sulting in 3.5 million fractures a year, which costs an
estimated €37 billion, or around 3% of overall health-
care costs.
But osteoporosis is often wrongly assumed to be a nat-
ural consequence of ageing, rather than a preventable
disease.
In this event report, EURACTIV takes a closer look at
the bone condition and ways in which it can be pre-
vented.
Contents
Osteoporosis prevention can
start in the womb, says health expert 4
Broken bones, shattered lives: call for action
as EU faces rise in osteoporosis 6
Pandemic could have far reaching effects on bone health,
expert warns 8
Osteoporosis and fragility fractures: An urgent
priority for European policymakers 10
4 EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV
Osteoporosis prevention can
start in the womb,
says health expert
B y N a t a s h a F o o t e | E U R A C T I V. c o m
Early preventative action is of paramount importance according
to Professor Cooper, president of the International Osteoporosis
Foundation. [SHUTTERSTOCK]
T
he narrative that osteoporosis cost-efficient osteoporosis-related health problem,” Cooper stressed,
is a natural consequence of fracture prevention, something he highlighting that there are 3.5 million
ageing must be challenged and says is well-substantiated in scientific osteoporosis-related fragility fractures
emphasis must be given to a smarter literature. in the EU each year, which cost an
way of screening to reduce the risk estimated €37 billion, or around 3% of
of fracture and the associated costs, Osteoporosis is a chronic condition overall healthcare costs.
the president of the International in which bones become weak and
Osteoporosis Foundation, told brittle, leading to fractures and breaks As populations age, this cost is
EURACTIV in an interview. which often carry life-debilitating predicted to increase by 25% by 2025,
consequences. with fracture-related costs projected
Professor Cyrus Cooper outlined to increase to €47.4 billion by 2030.
a three-step strategy for effective and “These fractures are a huge public
Continued on Page 5
EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV 5
Continued from Page 4
However, osteoporosis is those most at risk; and prevention Tool (FRAX), to evaluate the 10-year
often incorrectly assumed to be a over the whole life course, which can risk of fracture as a basis for further
natural part of ageing, rather than a start from pregnancy. intervention.
preventable disease.
“There are parts of the By altering the screening
“When I started out, osteoporosis environment which influence approach in this way, three major
was seen as an inevitable consequence bone density from before you’re studies conducted in the EU
of ageing, like grey hair,” Cooper said, born and from a very young age,” demonstrated a considerable benefit.
emphasising that research over the he said, adding that vitamin D
ensuing decades has now identified supplementation in pregnant One British study found that this
its risk assessment and treatment. women during winter months and led to a 26% reduction in hip fractures
maintaining calcium levels in young across 5 years, while all studies
This must now be reflected children has been shown to give showed a reduction in osteoporotic
in the way in which we approach children a better trajectory. fractures.
osteoporosis care, he said, both for
the human cost and the economic Whereas secondary prevention Later screening was also found to
burden of the condition. is already practised to a greater or reduce the associated costs to as little
lesser extent across EU member as £10,000 per QALY.
“Osteoporosis should join states, Cooper stressed that more
hypertension, diabetes, and high emphasis must also be given to Cooper said that on the back of this
cholesterol as one of the disorders primary prevention. new research, experts working in the
where you’ve got a known risk specialty agree that a stronger focus
factor and a load of interventions, In the past, screening practises must be given to screening practices,
and you need to link data so that have been shown to be inefficient, although he stressed that getting a
the interventions can be used most costing around €100,000 pounds consensus from national screening
effectively for those at a higher risk,” per quality-adjusted life-year councils is a “big challenge”.
he said. (QALY,) something Cooper says is
“economically unjustifiable”. One way which Cooper thinks
These risk factors, he added, could help improve osteoporosis care
should be seen in the same way that QALY is a generic measure of and prevention is via the use of data
blood pressure is related to stroke disease burden, with one QALY and digital technologies.
risk. equalling one year in perfect health,
used in economic evaluation to assess “I think that the use of big data
Early preventative action is the value of medical interventions. is an absolute priority and must be
therefore of paramount importance, used more,” he said, adding that this
Cooper underlined, saying that, The average willingness-to- must be facilitated at the EU level.
thanks to in-depth research, pay threshold is valued between
screening programmes have been €20,000-30,000 per QALY in the EU. “EU policy can definitely
refined to offer optimal outcomes. enhance the sharing of routine
However, Cooper cited new health statistics, amalgamation of
He highlighted a three-pronged studies which have demonstrated risk models across EU countries,
approach: secondary prevention, promising results by increasing the standardisation of integrated care
focusing on appropriate post- average age in which people are pathways and electronic health
fracture care; primary prevention, screened from 50-64 to 70-85, and records. All could be facilitated
which involves the implementation introducing a simple questionnaire, by current EU harmonisation
of screening programmes to detect known as a Fracture Risk Assessment programmes,” he said.
6 EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV
Broken bones, shattered lives:
call for action as EU faces rise in
osteoporosis
B y N a t a s h a F o o t e | E U R A C T I V. c o m
EU policy has been slow to keep pace with medical and clinical
advancements, leaving millions of people – mostly older women –
without access to the care and support they need to live full, independent
lives. [SHUTTERSTOCK]
E
U policy action on osteoporosis Partnership in conjunction with the care and support they need.
is lagging behind, even though a group of experts, aims to better
methods already exist to prevent manage osteoporosis and its related “The time has come for urgent
the chronic bone disease. But a new complications. action on osteoporosis, uniting
policy toolkit aims to help change this. patient, carer and clinical leadership
By summarising the key actions with wider societal and political
In an effort to align health policy for policymakers alongside country- advocacy actors in order to strengthen
with the latest tools and procedures, specific resources, the report aims the call for change,” the report urges.
the new toolkit, developed by health to ensure that EU policy helps those
policy consultancy, the Health Policy suffering from the condition access Osteoporosis is a chronic condition
Continued on Page 7EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV 7
Continued from Page 6
in which bones become weak and have been identified in order to slow, effective policy change,” but that “the
brittle, leading to fractures, known or even reverse, bone weakening, assembly of a robust clinical evidence
as ‘fragility fractures’, and breaks subsequently reducing the risk of a base must antecede translation
which often carry life-debilitating fracture. through the implementation of
consequences. policy change”.
“We now know what works in
These fractures are a major a clinical setting for osteoporosis, “We have proved that this is
cause of disability and early we’ve identified a means of a cost-effective use of healthcare
death in older adults. As well as predicting fracture risk, we have a resources that works in the UK, and
causing considerable mental and panoply of interventions that reduce now we want to bring post-fracture
psychological distress, they also fractures in those who are high risk, care on a larger scale to European
severely impair people’s abilities to and that is the basis that we need policy,” he added.
participate in normal life and their to communicate as the evidence
ability to work. to policy makers,” Professor Cyrus Ed Harding, managing director
Cooper, President of the International at the Health Policy Partnership,
With a hip fracture, for example, Osteoporosis Foundation, stressed said that he hoped this toolkit would
40% of patients cannot walk during a recent event marking the enable advocates to communicate the
independently, while 10–20% need launch of the toolkit. urgency for action on osteoporosis
permanent residential care. Despite this, EU policy has been and fragility fractures, adding that
slow to keep pace with medical the costs of inaction on this matter
In the EU alone, it’s estimated that and clinical advancements, leaving make a clear economic case for
22 million women and 5.5 million millions of people – mostly older change.
men suffer from the bone condition, women – without access to the care
resulting in 3.5 million fractures and support they need to live full, “Osteoporosis and fragility
a year, which costs an estimated independent lives. fractures need to be framed as part
€37 billion, or around 3% of overall of a solution for wider health system
healthcare costs. As it currently stands, across priorities and societal interests,”
Europe, almost 70% of women over he said, stressing its importance in
This number is set to increase 70 who have osteoporosis have not response to health system pressures
dramatically in the coming decades been diagnosed, and even after and contributing to the effective use
due to ageing populations and a fracture, 60–85% of women do of resources.
lifestyle changes, with fracture- not receive treatment to prevent
related costs projected to increase to subsequent fractures from occurring.
€47.4 billion by 2030.
Cooper emphasised that effective
However, clear, actionable steps clinical practice is “at the heart of8 EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV
Pandemic could have far
reaching effects on bone health,
expert warns
B y N a t a s h a F o o t e | E U R A C T I V. c o m
There must be a stronger focus on prevention and more work must
be done to educate and reorientate the way people think about bone
health, according to Jane Barratt, secretary-general of the international
federation of ageing. [SHUTTERSTOCK]
T
he COVID pandemic may have both in terms of delaying crucial early Highlighting the importance of
far-reaching consequences diagnosis of bone issues, but also the prevention and promotion of bone
on bone health, due to a lack of day to day physical activity health as an issue, she also raised
combination of lack of physical which could have a huge effect on concerns that, with economies reeling
activity and late diagnosis, according bone health,” Barratt told EURACTIV. from the effects of the pandemic, bone
to Jane Barratt, secretary-general of health may not receive the attention
the international federation of ageing. She added that the effects of this that it merits.
will not be felt immediately, but in the
“There is no question that COVID years to come. “Investments in preventative
is having an impact on bone health, measures as a percentage of GDP are
Continued on Page 9EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV 9
Continued from Page 8
already shamefully low,” she stated, to have a conversation about bone of developing and maintaining
adding that this is something that health which is separated from age,” the functional ability that enables
may only worsen as health care she said, stressing that “chronological wellbeing in older age.
services come under strain and face age is not the same as bone health
budgetary cuts in the future. age” and that bone health is strongly Functional ability is about having
linked with what happens over the the capabilities that enable all people
This is despite the fact that course of an individual’s lifetime. to be and do what they have reason to
bone fragility carries “devastating” value, Barratt explained, highlighting
consequences. As such, there must be a stronger that bone health underpins the goals
focus on prevention and more of the healthy ageing decade and, as
“Hip fractures are particularly work must be done to educate and such, should be placed high on the
devastating, and osteoporotic falls reorientate the way people think priority list.
are increasing. This means people about bone health.
are not able to retain function, and “This new way of approaching
require long term care which is both In particular, she highlighted healthy ageing is a great opportunity
costly and means people are unable the role of intergenerational to raise the profile of bone issues,
to live their lives the way they want,” programmes, including more work and this has to be reflected health
she said, adding that there is simply done at the school level, to teach investments in the future,” she said.
not enough policy focus on the issue. about nutrition and bones, as well as
the importance of regular exercise in
For example, in the EU alone, it early age.
is estimated that 22 million women
and 5.5 million men suffer from “We need to talk about the
the bone condition, resulting in 3.5 importance of bone health from
million fractures a year, which costs an early age,” she stressed, adding
an estimated €37 billion, or around that education programmes must
3% of overall healthcare costs. take into account the fact that the
level of health literacy varies within
One of the biggest challenges populations.
is the perception that bone health
is an issue of the elderly, rather This more integrated approach to
than something to focus on the bone health is in line with the new
importance of bone health over the way of thinking about growing older,
life course. as seen in the recently launched
UN decade of healthy ageing 2021-
“We have to figure out a way 2030, which focuses on the process10 EVENT REPORT | PREVENTING OSTEOPOROSIS IN THE EU | EURACTIV
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Osteoporosis and fragility fractures:
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