The economic benefits of fracture prevention

Osteoporosis-related fractures represent a significant and growing public health concern, especially in aging populations. Despite the availability of effective treatments, significant care gaps persist in both primary and secondary prevention.

This narrative review synthesizes key findings from economic evaluations examining the cost-effectiveness of pharmacological and non-pharmacological therapies, fracture liaison services (FLS), and FRAX®-based intervention thresholds. Relevant literature was reviewed, including systematic reviews, country specific studies, and emerging data on novel technologies. The evidence consistently demonstrates that fracture prevention strategies are cost-effective across diverse healthcare settings. Pharmacological monotherapy and sequential regimens have shown favorable economic profiles, while FLS programs, although resource-intensive, significantly reduce re-fracture rates and associated costs. Intervention thresholds should be derived clinically, with health economic modeling used to evaluate their cost-effectiveness so as to guide rational, risk-based treatment strategies.

Health economic evaluations are increasingly enabling the development of osteoporosis treatment strategies, highlighting the strong cost-effectiveness potential of these interventions. However, challenges remain including heterogeneity in analytical approaches, under-representation of low- and middle-income countries, and limited incorporation of real-world (adherence) data. Maintaining methodological consistency, expanding region-specific data, and evaluating emerging technologies with robust economic frameworks are essential steps toward achieving globally equitable and cost-effective osteoporosis care.