Recently, the Public Health Agency of Canada recognized osteoporosis as a major public health concern in Canada and highlighted the need to focus on secondary fracture prevention and its negative consequences, while facing a large care gap and a rapidly aging Canadian population. The economic burden of fragility fractures in Canada was estimated at CAD$4.6 billion in 2014 with acute care accounting for the greatest proportion (33%) of the total economic burden. Osteoporotic fractures are associated with considerable direct and indirect costs.
In a recent real-world study in Canadian patients aged 65 years and older with a fracture, nearly 18% incurred a second fragility fracture, and the median time to second fracture was less than 2 years. On average, the risk of subsequent fracture is highest 1 to 2 years after the initial fracture. Once a postmenopausal woman has her first fracture due to osteoporosis, she is five times more likely to fracture again within a year, and her risk remains elevated over time. The number of fragility fractures in those aged 50 years and older is expected to increase by 24% from 2015 to 2030. In Canada, the crude fracture rate in 2015 was approximately 16 fragility fractures per 1000 persons aged ≥ 50 years, and the lifetime probability of hip fracture at age 50 years was 8.9%. Patients may require long-term institutional care as a result of their fracture, with as many as 37% of patients entering long-term care in Canada following a hip fracture. Fragility fractures are also associated with an increased risk of mortality, which may persist for several years, particularly for hip fractures. Fragility fractures can result in loss of independence for patients and increased burden for themselves and their caregivers. Postmenopausal osteoporosis (PMO) is a chronic disease characterized by compromised bone strength due to bone loss that puts women at high risk of suffering debilitating fractures.
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