Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA).

Osteoporosis, literally “porous bone”, is a disease characterized by weak bone. It is a major public health problem, affecting hundreds of millions of people worldwide, predominantly postmenopausal women. The main clinical consequence of the disease is bone fractures. It is estimated that one in three women and one in five men over the age of fifty worldwide will sustain an osteoporotic fracture. Hip and spine fractures are the two most serious fracture types, associated with substantial pain and suffering, disability, and even death. As a result, osteoporosis imposes a significant burden on both the individual and society. During the past two decades, a range of medications has become available for the treatment and prevention of osteoporosis. The primary aim of pharmacological therapy is to reduce the risk of osteoporotic fractures. The objective of this report is to review and describe the current burden of osteoporosis and highlight recent advances and ongoing challenges for treatment and prevention of the disease. The report encompasses both epidemiological and health economic aspects of osteoporosis and osteoporotic fractures with a primary geographic focus on France, Germany, Italy, Spain, Sweden, and the UK. Projections of the future prevalence of osteoporosis and fracture incidence, the total societal burden of the disease, and the consequences of different intervention strategies receive special attention. The report may serve as a basis for the formulation of healthcare policy concerning osteoporosis in general and the treatment and prevention of osteoporosis in O. Ström : F. Borgström Department of Learning, Informatics, Management, and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden and Innovus, Stockholm, Sweden J. A. Kanis WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK J. Compston Department of Medicine, Addenbrooke’s Hospital, Cambridge University, Cambridge, UK C. Cooper MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK C. Cooper NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK E. V. McCloskey Academic Unit of Bone Metabolism, Northern General Hospital, Sheffield, UK E. V. McCloskey WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK B. Jönsson (*) Department of economics, Stockholm School of Economics, Box 6501, SE 11383 Stockholm, Sweden e-mail: [email protected] Arch Osteoporos (2011) 6:59–155 DOI 10.1007/s11657-011-0060-1