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NEW REPORT URGES EU GOVERNMENTS TO ADDRESS INADEQUATE DXA SCANNING FACILITIES

European Parliament Osteoporosis Interest Group says that "much has been achieved, but a lot remains to do", and called on EU policy makers to take action to ensure commitments to prevent, diagnose and treat this disease are met.

European Parliament, Brussels
November 10, 2004

The number and availability of DXA scanners in Europe is inadequate to effectively diagnose and treat osteoporosis fractures, according to a report released today.

DXA (dual energy X-ray absorptiometry), is the most reliable way to determine bone density, a major risk factor of fractures.

The report, "Requirements for DXA for the management of osteoporosis in Europe", was written by John Kanis, WHO Collaborating Centre for Metabolic Bone Diseases and IOF Board member, and Olof Johnell, vice chairman of the IOF Committee of Scientific Advisors. It will be published in the peer-reviewed journal Osteoporosis International (in press, 10.1007/s00198-004-1811-2.)

The authors highlighted the level of shortfall of DXA scanners in Europe. Looking at data on fractures from a large number of European countries, they concluded that, even with effective screening, both DXA availability and usage was sub-optimal in many countries. According to the report the burden of osteoporosis would continue to grow dramatically unless decisive action is taken now at national and European levels.

The report was discussed at a meeting of the European Parliament's Osteoporosis Interest Group. The group is calling for EU Member States to take concrete action to ensure that those at risk from osteoporosis receive timely diagnosis, life style advice and treatment, as outlined in the 1998 Recommendations of the European Commission. To aid this goal Mary Honeyball, MEP and Angelika Niebler, MEP, on behalf of the group, called for a Council Conclusion on Osteoporosis to ensure that priority is given to this disease at national level. Over 70 committed stakeholders, including MEPs, Commission officials, national health advisors, NGOs, from more that 20 Member States, including representatives from the new EU Member States, attended the meeting.

During the meeting Professor Juliet Compston, International Osteoporosis Foundation board member and chair of the EU Osteoporosis Consultation Panel, stressed the large amount of good work already done at a political level in many Member States, including

Finland government supports programme to improve diagnosis and treatment of fragility fractures;
France osteoporosis becomes a national health priority in its new public health legislation;
Greece new awareness-raising campaign endorsed by Ministry of Health;
Ireland government funding provided for the Irish Osteoporosis Society;
Italy Senate recommendations on management of osteoporosis are being implemented by regional health authorities;
Portugal Ministerial approval of strategic plan for rheumatic diseases – including osteoporosis;
Spain widespread distribution and promotion of European Osteoporosis Action Plan to policy makers, Senate hosting meeting in Parliament on Osteoporosis on 25th November 2004

Professor Compston praised these initiatives, but reiterated the thoughts of the Osteoporosis Interest Group, saying "we welcome these initiatives, but much more needs to be done,". Many countries fail to identify those at risk early enough due to insufficient resources. Usage of existing screening facilities is also denied to people with low incomes in some countries, such as France and Belgium, as they are not reimbursed.

Co-chair of the Interest Group, Mary Honeyball MEP, pointed out that by making osteoporosis a healthcare priority governments would save considerable unnecessary expenditure. Mrs Honeyball was backed up by her co-chair, Angelika Niebler, who added that it was time that this crippling disease received the political attention that it deserved especially as cost effective preventive strategies already existed. Both concluded that continued momentum was necessary, and that the Parliamentary Osteoporosis Interest Group would continue to drive the agenda. They urged Members States to agree to a Council Conclusion in favour of osteoporosis which would help ensure that those at risk from osteoporosis get the diagnosis, lifestyle advice and treatment that they need. For a summary of the Kanis and Johnell report please see attached document.

For further information please contact

Mary Anderson, EU policy
co-coordinator and IOF Board Member
Email: manderson@osteofound.org
Website: www.osteofound.org

Gráinne Crowley
Weber Shandwick, Brussels. Belgium
Tel: +32 2 282 1625
Email: gcrowley@webershandwick.com

ENDS

Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases, death. One out of three women over 50 will experience osteoporotic fractures, as will one out of five men 1, 2, 3. Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain extent, be prevented, it can be easily diagnosed and effective treatments are available.

The International Osteoporosis Foundation (IOF) is the only worldwide organization dedicated to the fight against osteoporosis. It brings together scientists, physicians, patient societies and corporate partners. Working with its 169 member societies in 84 locations, and other healthcare-related organizations around the world, IOF encourages awareness and prevention, early detection and improved treatment of osteoporosis.

1 Melton U, Chrischilles EA, Cooper C et al. How many women have osteoporosis? Journal of Bone Mineral Research, 1992; 7:1005-10
2 Kanis JA et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis International, 2000; 11:669-674
3 Melton LJ, et al. Bone density and fracture risk in men. JBMR. 1998; 13:No 12:1915

Background to the European Parliament Osteoporosis Interest Group

The European Parliament Osteoporosis Interest Group is an informal, all-party group founded by a former MEP, Mrs Mel Read, in December 2001, to help stimulate much needed policy developments at both national and European levels. The International Osteoporosis is the secretariat for the Group.

Over the last three years members of the Interest Group have played an important role in increasing political awareness about osteoporosis both at European and national levels by participating in awareness activities and by supporting relevant legislation. Since the recent European Parliament elections the Interest Group has been reformed with Mary Honeyball MEP and Angelika Niebler MEP as co-chairs. The Group is committed to improving policies for osteoporosis by playing an active role in the Call for Action.

European Parliament Osteoporosis Interest Group Members

Adamos Adamou MEP, Cyprus
Georgs Andrejevs MEP, Latvia
Mojca Drcar Murko MEP, Slovenia
Pilar Ayuso Gonzalez MEP, Spain
John Bowis MEP, UK
Milan Cabrnoch MEP, Czech Republic
David Casa MEP, Malta
Charlotte Cederschiöld MEP, Sweden
Dorette Corbey MEP, The Netherlands
Proinsias De Rossa MEP, Ireland
Den Dover MEP, UK
Françoise Grossetête MEP, France
Mary Honeyball MEP, UK
(Co-chair)

Richard Howitt MEP, UK
Caroline Jackson MEP, UK
Karin Jöns MEP, Germany
Rodi Kratsa-Tsagaropoulou MEP, Greece
Lasse Lehtinen MEP, Finland
Astrid Lulling MEP, Luxembourg
Elizabeth Lynne MEP, UK
Arlene McCarthy MEP, UK
Angelika Niebler MEP, Germany
(Co-chair)
Péter Olajos MEP, Hungary
Borut Pahor MEP, Slovenia
Frédérique Ries MEP, Belgium
Karin Scheele MEP, Austria
Catherine Stihler MEP, UK
Diana Wallis MEP, UK
Anna Záborská MEP, Slovakia

For further information about the International Osteoporosis Foundation and the European Parliament Osteoporosis Interest Group please visit: www.osteofound.org

REQUIREMENTS FOR DXA FOR THE MANAGEMENT OF OSTEOPOROSIS IN EUROPE

Abstract

The availability of dual energy X-ray absorptiometry (DXA) varies markedly in different countries. There is, however, little information to indicate the optimal requirements for this technology. The principal aim of this study was to estimate the requirements for DXA in Europe for the assessment and treatment of osteoporosis. Three assessment scenarios were chosen. The first envisaged screening of all women with DXA at the age of 65 years. A second scenario comprised a screening programme based on the identification of clinical risk factors with the selective addition of BMD tests in those close to an intervention threshold. The third scenario envisaged a case finding strategy where women aged 65 years were identified on the basis of risk factors and referred for DXA. Requirements for women aged more than 65 years were amortised over a 10-year period. A secondary aim was to estimate the number and cost of osteoporotic fractures in Europe.

The requirements for DXA in assessment ranged from 4.21 to 11.21 units/million of the population. The most efficient assessment scenario was the use of clinical risk factors with the selective use of BMD. With this scenario an additional 6.39 units/million would be required to monitor treatment giving a total requirement of 10.6 units/million.

In 2000 the number of osteoporotic fractures was estimated at 3.79 million of which 0.89 million were hip fractures (179,000 hip fractures in men and 711,000 in women). The total direct costs were estimated at €31.7 billion (£21.165 billion) which were expected to increase to €76.7 billion (£51.1 billion) in 2050 based on the expected changes in the demography of Europe.

Contact for further information:

The report was written by JA Kanis1 and O Johnell2, on behalf of the Committee of Scientific Advisors of the International Osteoporosis Foundation (Osteo Int. in press, 10.1007/s00198-004-1811-2.)

1 WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK
2 Department of Orthopaedics, Malmo General Hospital, S-214 01 Malmo, Sweden

Prof Kanis, WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK.
Tel: +44 114 285 1109
Fax: +44 114 285 1813
Email: w.j.pontefract@shef.ac.uk

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