Osteoporotic fractures: risk estimation, possible therapies and related costs

Osteoporosis affects about 200 million subjects in the world and is responsible for 8.9 million fractures each year. The combined annual cost of all osteoporotic fractures in Europe has been estimated to be 30 billion Euros. The frequency of osteoporotic fractures is rising in many countries, in particular because of the increased longevity of the population. In Italy, around 4 million of women and more than 800,000 men are exposed to a high fracture risk. The National Healthcare System spends about 500 million Euros for hospitalization and chirurgical treatment of hip fractures and costs related to rehabilitation are even greater. The situation is more critical in southern Italy, where the incidence of elderly people is higher than in the other regions. Therefore, there is a strong need for the assessment of the best practices in prevention and treatment of osteoporosis. In this paper, after an overview of the socioeconomic impact of osteoporosis in Italy, with particular focus on Apulia region, the most important techniques used to assess the fracture risk are briefly described. In general, they fall into two major categories: physical measurement of skeletal mass and assessment of clinical risk factors. Moreover, the most commonly used pharmacological agents for the treatment of osteoporosis are reported. In conclusion, for a correct management of the disease, it would be necessary to encourage the widespread use of cheap and non-invasive screening techniques for early diagnosis of osteoporosis.