New Report Reveals 1 Fracture Occurs Every Minute in France’s Population

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A report discovered an estimated 500,0000 fragility fractures occur annually in France—an equivalent to 1 fracture per minute.¹

“Fragility fractures are among the top five highest chronic disease burdens in France, exceeding even pulmonary heart disease and ischemic stroke,” said co-author Karine Briot, president of the Groupe de Recherche et d’Information sur les Ostéoporoses (GRIOR) and professor of rheumatology at Hôpital Cochin in Paris, in a press release.²

There is a growing burden of osteoporosis-associated fractures. Due to the burden, the International Osteoporosis Foundation completed the report, “Solutions for Fracture Prevention in France,” to closely examine the national osteoporosis-related burden and current healthcare policies regarding this bone disease. The International Osteoporosis Foundation collaborated with leading French bone disease experts: Thierry Thomas, Bernard Cortet, Julien Paccou, and Briot.¹

Fractures pose a large financial burden to patients, caregivers, and as a result, the healthcare system. In 2019, the French population had 484,000 new fragility fractures, with 1325 fractures per day and 55 fractures per hour. The report showed 5.5% (n = 3,991,000) of the total population had osteoporosis, with 79.9% being women and 20.1% being men.

The estimation of direct costs and expenditure for long-term disability in 2019 was > €7 billion a year, with €1.8 billion in long-term disability costs, € 5.1 billion in direct cost of incident fractures, and €162 million in pharmacological intervention. The FRACTOS study found the total cost of individual fractures, including follow-up costs > 12 months, had costs of €23,926, €14,561, and €6,905 for each hip, vertebral, and wrist fracture, respectively.

The new report revealed an initial fracture is linked to a 12.5% risk of re-hospitalization within a year and a 16.6% risk of all-cause mortality following a hip fracture. With the aging population, the fracture burden is predicted to escalate. Fragility fractures are estimated to increase by 26% from 2019 to 2034.

The report also estimated 2 million French women had a high fracture risk if their osteoporosis was untreated, despite the availability of safe and effective medications to reduce bone risk and fracture risk.

“This situation is highly concerning and unacceptable when one considers the significant human suffering resulting from fragility fractures,” Briot said.²

The report revealed fragility fractures nearly double the risk of having another fracture, particularly in the first 24 months.¹ More than three-quarters of French women aged ≥ 50 years who had an initial fracture do not receive timely treatment to prevent subsequent fractures. This is due to the fact France has a lack of fracture liaison services—facilities that provide care to people post-fracture.

“The French population is underserved with fracture liaison services. Currently, fewer than 10% of French hospitals have such a service,” said co-author Cortet, professor at Roger Salengro Hospital at the University Hospital of Lille. ² “This represents a substantial missed opportunity to stop the cycle of recurring fractures that so many patients go on to experience. With a realistic implementation of FLS in France, there would be substantial improvements in patient health and outcomes, with concurrent reductions in hospitalizations and cost savings.”

France prioritizes fragility fractures within healthcare management and has a solid foundation called Ma Santé 2022 which outlines strategy for osteoporosis policy.¹ The “return home program” offers rehabilitation support after a fracture.

The report also noted a strong track record of cooperation among leading medical organizations in the musculoskeletal field. The report ultimately emphasized growing fracture liaison services to increase post-fracture screening, diagnosis, and treatment rates.

“IOF urges policymakers in France to implement effective solutions to tackle the fragility fracture crisis,” said Philippe Halbout, the International Osteoporosis Foundation CEO.² “The targeted, collaborative actions proposed in this new report would lead to fewer fractures, improved patient outcomes, reduced healthcare costs, and, most crucially, enhanced mobility for France's elderly population.”

References

1. ^{Solutions for Fracture Prevention. International Osteoporosis Foundation. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.osteoporosis.foundation/sites/iofbonehealth/files/2024-08/2022_country_profile_fr-english.pdf. Accessed September 10, 2024.}
2. ^{In France, one fracture per minute due to osteoporosis. EurekAlert! September 3, 2024. https://www.eurekalert.org/news-releases/1056494. Accessed September 10, 2024.}