Despite their high incidence and the substantial associated morbidity, mortality, and cost to health care and social services, osteoporotic fractures remain under-recognised and under-treated. This neglect has persisted despite advances that have enabled accurate fracture risk prediction and the availability of a range of cost-effective therapeutic interventions to reduce fractures. A new report, issued by the US National Osteoporosis Foundation, provides a stark reminder of the burden of these fractures and emphasises the potential of strategies for the secondary prevention of fractures to reduce suffering and economic costs. The report, which focuses on the US Medicare population, found that about 2 million Americans had 2·3 million osteoporotic fractures in 2015 and that hospitalisation due to these fractures exceeded that due to breast cancer, heart disease, and stroke combined. Only 9% of those with a fracture underwent bone mineral density testing within 6 months of the fracture, and in the first 2–3 years following fracture, 307 000 individuals had a second fracture, incurring additional costs of more than US$6·3 billion. On the basis of the conservative assumption that pharmacological intervention would reduce 20% of these secondary fractures, potential savings of more than $1 billion could be realised if preventive measures were fully implemented.

中文翻译：

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缩小骨质疏松症的治疗差距。

尽管骨质疏松性骨折的发病率很高，并且与发病率，死亡率以及医疗保健和社会服务费用相关，但仍未得到充分认识和治疗。尽管取得了一些进展，这些进展使人们能够准确地预测骨折风险，并且可以使用各种经济有效的治疗手段来减少骨折，但这种忽视仍然持续存在。美国国家骨质疏松基金会发布的一份新报告清楚地提醒了这些骨折的负担，并强调了二级预防骨折以减少痛苦和降低经济成本的策略的潜力。这份针对美国医疗保险人群的报告发现，2015年约有200万美国人患有2·300万骨质疏松性骨折，这些骨折导致的住院治疗超过了乳腺癌造成的住院治疗，心脏病和中风合并。只有9％的骨折患者在骨折后的6个月内接受了骨矿物质密度测试，在骨折后的前2-3年中，有307 000人发生了第二次骨折，产生的额外费用超过了60亿至30亿美元。 。根据保守的假设，即药物治疗将减少这些继发性骨折的20％，如果完全采取预防措施，则可以节省超过10亿美元。