Epidemiology and Economics of Osteoporosis Management

Osteoporosis is a major public health concern globally more so in India, with a notable increase in hip fractures, among males and Postmenopausal women. These fractures occur 10 to 20 years earlier in the Indian population with peak incidence between 50 to 60 years. The fact that 30% of fracture patients in India die within a year indicates the severity. A meta-analysis of studies from 2010 to January 2021, reported a pooled prevalence of osteoporosis at the lumbar spine region and the femoral neck region as 29%, the hip region as 6%. Similarly, the pooled prevalence of osteopenia at the lumbar spine region and femoral neck region is reported to be 37% each, and the hip as 6%. Osteoporosis diagnosis primarily involves assessing bone mineral density (BMD). In India current guidelines recommend osteoporosis screening for individuals over 65, and postmenopausal women, over 50 years. Lower BMD scores are linked to higher fracture risk, in older adults. For example, at age 50, a T-score of -2.5 correlates to a 12% fracture risk, which can double or triple by age 70. Materials and Methods: An unpleasant surprising diagnosis of osteoporosis in author’s wife following unintended BMD Test is the trigger for this article, complimented by extensive literature review, about the latest treatment approaches. Currently the patient is under treatment with both traditional (Calcium and Vitamin D supplementation) and modern treatment with Denosumab (DENU) a Monoclonal antibodies subcutaneous injection, the cost of which is forbidding for an average Indian. Outcome: The Denu injection was well accepted by the patient with only minor adverse reaction of local pain and fever for a day. Though costly modern treatments is worth investing in elderly post-menopausal women’s Healthy ageing and Healthy Average Life Expectancy (HALE) of women in the country.