Original Research

Calcified Tissue International

, Volume 93, Issue 1, pp 1-14

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Health Technology Assessment in Osteoporosis

  • Mickael HiligsmannAffiliated withDepartment of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht UniversityDepartment of Public Health, Epidemiology and Health Economics, University of Liège Email author 
  • , John A. KanisAffiliated withWHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School
  • , Juliet CompstonAffiliated withDepartment of Medicine, Cambridge University Hospitals NHS Foundation Trust
  • , Cyrus CooperAffiliated withMRC Lifecourse Epidemiology Unit, University of Southampton
  • , Bruno FlamionAffiliated withPhysiology and Pharmacology Department, University of Namur
  • , Pierre BergmannAffiliated withDepartment of Radioisotopes, CHU Brugmann, Université Libre de Bruxelles
  • , Jean-Jacques BodyAffiliated withDepartment of Medicine, CHU Brugmann, Université Libre de Bruxelles
  • , Steven BoonenAffiliated withCenter for Metabolic Bone Diseases, Katholieke University Leuven
  • , Olivier BruyereAffiliated withDepartment of Public Health, Epidemiology and Health Economics, University of Liège
    • , Jean-Pierre DevogelaerAffiliated withDepartment of Rheumatology Saint Luc University Hospital, Université Catholique de Louvain
    • , Stefan GoemaereAffiliated withDepartment of Rheumatology and Endocrinology, Ghent University Hospital
    • , Jean-Marc KaufmanAffiliated withDepartment of Endocrinology, Ghent University Hospital
    • , Serge RozenbergAffiliated withDepartment of Gynaecology–Obstetrics, CHU Saint-Pierre, Université Libre de Bruxelles
    • , Jean-Yves ReginsterAffiliated withDepartment of Public Health, Epidemiology and Health Economics, University of Liège


We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe’s six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.


Burden of disease Cost-effectiveness Economic evaluation Health technology assessment Osteoporosis