Two-thirds of high-risk osteoporosis patients in Germany remain untreated: Report

More than 831,000 fragility fractures occur annually in Germany, which equates to 95 fractures per hour. The cause is osteoporosis, a disease that makes the skeleton weak and brittle, increasing the risk of fragility fractures that can lead to disability, loss of independence, and early death for some patients.

Nearly 5.6 million people nationwide suffer from osteoporosis, of whom 4.5 million are women. Despite the availability of effective and safe agents to reduce the risk of fragility fractures, significant treatment gaps still exist. It is estimated that women over the age of 50 are at an increased risk of fractures, or about 2.5 million, or about 76% of all women. Osteoporosis is left untreated.

The Capture the Fracture program of the International Osteoporosis Foundation (IOF), in collaboration with Germany’s leading experts, has published a new report entitled ‘Solutions for fracture prevention in Germany’. This report reviews the osteoporosis burden and health policy landscape in Germany and suggests important strategies aimed at curbing the increasing incidence of costly fragility fractures.

Osteoporosis-related fractures and associated medical costs are rapidly increasing due to population aging

Co-author of the report, Dr. Uwe Maus, Head of Endoprosthetics and Osteology at Düsseldorf University Hospital and Vice-President of the German Osteological Society (DVO), said: “Fragility fractures are already a major problem in older people.” It’s a burden on our health.” “This is related to increased fiscal costs, which amounted to an estimated €13.8 billion in 2019. By 2050, he expects 30% of Germany’s population to increase compared to 19% in 2006 He will be a senior citizen over 65 years old.”

“This demographic shift threatens to significantly increase the incidence and societal burden of fragility fractures, straining the capacity of health systems, including the provision of long-term care. We must urgently address this pressing crisis. There is a clear need to introduce strategies to improve treatment initiation and adherence, with a focus on preventing fracture recurrence.”

Addressing the urgent need to prevent fracture recurrence

It is very important to identify and treat patients with fractures to reduce the risk of future fractures. A German study of approximately 18,000 fracture patients demonstrated that subsequent fractures occurred in 16% of patients during a 1-year follow-up period.

Another study found that 30% of patients over 70 years experienced at least one fracture during a median follow-up of 3.2 years. Femoral neck fractures are of particular concern because they are life-threatening, involve significant costs, and remain an economic burden.

In Germany, 12% of hip fracture patients are institutionalized within 6 months of discharge, and the risk of institutionalization increases exponentially with age. Approximately 21% of patients with femoral neck fractures die within 6 months after the fracture, and 28% die within 12 months.

Nevertheless, only 20-40% of German women receive anti-osteoporotic treatment within the first year of osteoporotic fracture, and drug retention rates are low, ranging from only 17-40%. It is estimated that there is.

Multidisciplinary, coordinator-based post-fracture care services, most commonly known as fracture liaison services (FLS), ensure these high-risk patients are identified and provided with the post-fracture care they need to regain health. This is a proven method. Increases mobility and prevents future fractures. Germany is currently slow in implementing FLS, with it available in only 1-10% of hospitals treating fracture patients.

Positive conditions for effective management outweigh gaps and missed opportunities

Germany has several positive prerequisites for effective osteoporosis management, including widely adopted management guidelines, robust data collection through a national hip fracture registry, and full reimbursement of osteoporosis drugs. .

Additionally, the approval of the Osteoporosis Disease Management Program (DMP) by competent government agencies has elevated osteoporosis to its rightful status as one of the most important chronic and progressive diseases. This means that from approximately 2023 onwards, patients diagnosed with osteoporosis and requiring anti-osteoporosis drugs could theoretically receive care within a structured treatment program.

Dr Peyman Hadji, professor of obstetrics, gynecology and endocrinology at Philips University in Marburg, Germany, and member of the IOF Scientific Advisory Board, said: “The approval of the DMP is an important step forward and a disappointing one. ”. Organizational and funding issues impede its advancement and dissemination. But this is just one of several challenges we face. ”

“The current disconnect between hospitals and primary care settings regarding the diagnosis and treatment of osteoporosis does not result in consistent implementation of robust treatment pathways to ensure appropriate post-discharge care. , is further hampered by a lack of electronic sharing systems, which means that critical information such as patient imaging results, past fractures, and prescribed treatments are not shared between hospitals and practitioners. To do. ”

The new report makes four key recommendations to address these key obstacles. These include the need for greater financial incentives for osteoporosis care and development of FLS, optimizing patients and treatment pathways, promoting increased uptake of FLS to increase post-fracture screening, diagnosis, and treatment rates, and improving osteoporosis. This includes raising the public’s awareness of

Dr. Philippe Halbaugh, CEO of the International Osteoporosis Foundation, thanked the many national experts who collaborated with the IOF Capture the Fracture Policy Group to publish recommendations, saying, “This valuable resource “When implemented together, these can serve as a guide to effective solutions.” This will reduce fractures, reduce healthcare costs, improve patient outcomes and, importantly, improve the health, mobility and quality of life of older people in Germany. ”