Economic burden of osteoporosis in India among treated populations (ECON-OP): a prevalence-based cost-of-illness analysis across key risk groups

Background: Osteoporosis is a major public health concern in India, leading to fractures, disability, and increased healthcare utilization. However, evidence on its economic burden in the Indian setting remains limited. This study estimated the economic burden of osteoporosis among treated patients in India and evaluated differences between primary and secondary prevention populations. Methods: A prevalence-based cost-of-illness model was developed for postmenopausal women (PMO), men aged ≥50 years, and patients with glucocorticoid-induced osteoporosis (GIOP). The analysis included treated patients only and applied a weighted healthcare cost mix of 70% public and 30% private sector utilization. Costs were estimated from payer and societal perspectives and reported in Indian Rupees (INR). Results: The total annual societal economic burden among treated patients was estimated at INR 22,773.6 crores, comprising INR 16,226.5 crores for PMO, INR 6,057.3 crores for male osteoporosis, and INR 489.7 crores for GIOP. Direct medical costs were the major contributor across all populations. Per-patient costs were substantially higher among fracture patients than non-fracture patients, reaching INR 2.15 versus 0.30 lakhs in PMO, INR 2.29 versus 0.35 lakhs in men, and INR 2.16 versus 0.34 lakhs in GIOP. Fracture-related costs were approximately seven-fold higher than costs in primary prevention populations. Scenario analyses suggested a markedly greater burden associated with untreated osteoporosis. Conclusions: Osteoporosis imposes a substantial economic burden in India, driven primarily by fracture-related costs. Early diagnosis, sustained treatment, and effective fracture prevention strategies may substantially reduce healthcare expenditure and societal burden.