Archives of Osteoporosis

, 14:114 | Cite as

The health and economic burden of osteoporotic fractures in Singapore and the potential impact of increasing treatment rates through more pharmacological options

  • Manju ChandranEmail author
  • Tang Ching Lau
  • Isabelle Gagnon-Arpin
  • Alexandru Dobrescu
  • Wenshan Li
  • Man Yee Mallory Leung
  • Narendra Patil
  • Zhongyun Zhao
Original Article



This study aims to estimate the health and economic burden of osteoporosis in Singapore from 2017 to 2035, and to quantify the impact of increasing the treatment rate of osteoporosis.


Population forecast data of women and men aged 50 and above in Singapore from 2017 to 2035 was used along with prevalence rates of osteoporosis to project the osteoporosis population over time. The population projections by sex and age group were used along with osteoporotic fracture incidence rates by fracture type (hip, vertebral, other), and average direct and indirect costs per case to forecast the number of fractures, the total direct health care costs, and the total indirect costs due to fractures in Singapore. Data on treatment rates and effects were used to model the health and economic impact of increasing treatment rate of osteoporosis, using different hypothetical levels.


Between 2017 and 2035, the incidence of osteoporotic fractures is projected to increase from 15,267 to 24,104 (a 57.9% increase) F 10,717 to 17,225 (a 60.7% increase) and M 4550 to 6878 (a 51.2% increase). The total economic burden (including direct costs and indirect costs to society) associated with these fractures is estimated at S$183.5 million in 2017 and is forecasted to grow to S$289.6 million by 2035. However, increasing the treatment rate for osteoporosis could avert up to 29,096 fractures over the forecast period (2017–2035), generating cumulative total cost savings of up to S$330.6 million.


Efforts to improve the detection, diagnosis, and treatment of osteoporosis are necessary to reduce the growing clinical, economic, and societal burden of fractures in Singapore.


Osteoporosis Osteoporotic fractures Economic burden Asia Singapore Health burden 


Funding information

This study was funded by Amgen Inc.

Compliance with ethical standards

Conflict of interest

Manju Chandran, Tang Ching Lau, Isabelle Gagnon-Arpin, Alexandru Dobrescu, and Wenshan Li have no conflict of interest. Mallory Leung, Narendra Patil, and Zhongyun Zhao hold Amgen stock and are employees of Amgen.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • Manju Chandran
    • 1
    Email author
  • Tang Ching Lau
    • 2
  • Isabelle Gagnon-Arpin
    • 3
  • Alexandru Dobrescu
    • 3
  • Wenshan Li
    • 3
  • Man Yee Mallory Leung
    • 4
  • Narendra Patil
    • 4
  • Zhongyun Zhao
    • 4
  1. 1.Osteoporosis and Bone Metabolism Unit, Department of EndocrinologySingapore General HospitalSingaporeSingapore
  2. 2.Department of Medicine (Rheumatology)National University Hospital, NUHS Tower BlockSingaporeSingapore
  3. 3.Conference Board of CanadaOttawaCanada
  4. 4.Amgen Asia Holding Ltd.Quarry BayHong Kong

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