The burden of osteoporosis in Saudi Arabia: a scorecard and economic model

Figures & data

Figure 1. Scorecard for osteoporosis in Saudi Arabia. Abbreviations. DXA, dual-energy x-ray absorptiometry; FLS, fracture liaison service; FRAX, fracture risk assessment model; NHP, national health priority.

Table 1. Epidemiological measures of osteoporosis burden in Saudi Arabia.

Measure	Value
Age-standardized^a incidence of hip fracture in women^8^,^17^,^19	561/100,000
Crude fragility fracture rate among men and women aged 50–89 years in 2015^8^,^19^,^33	33/1,000
Prevalence of osteoporosis in post-menopausal women^40	34%
Percentage increase in number of fragility fractures in men and women aged 50–89 years from 2015 to 2030^8^,^19^,^33	130%

^a Standardized to the world population of females in 2010.

Table 2. Estimated number of fractures among adults aged 50–89 years in Saudi Arabia.

Fracture site	Number of fractures in 2019	Number of fractures in 2023	Percentage increase (from 2019 to 2023)
Vertebral	27,239	34,837	27.9
Wrist	30,896	39,675	28.4
Hip	17,467	22,220	27.2
Other	98,624	125,721	27.5
Total	174,225	222,454	27.7

Table 3. Estimated economic burden of osteoporosis in Saudi Arabia for 2019.

Cost category	1-year burden	1-year burden per 1,000 at risk	5-year burden
Hospital	SR1,000,469,941	SR190,250	SR5,667,347,965
	$266,791,984 USD	$50,733 USD	$1,511,292,791 USD
	$650,077,934 PPP	$123,619 PPP	$3,682,487,307 PPP
Testing	SR567,537,218	SR107,923	SR3,218,493,980
	$151,343,258 USD	$28,780 USD	$858,265,061 USD
	$368,770,122 PPP	$70,125 PPP	$2,091,289,136 PPP
Surgical	SR324,301,394	SR61,669	SR1,833,342,205
	$86,480,372 USD	$16,445 USD	$488,891,255 USD
	$210,722,153 PPP	$40,071 PPP	$1,191,255,494 PPP
Prescription drugs	SR491,593,389	SR93,482	SR2,772,279,004
	$131,091,570 USD	$24,928 USD	$739,274,401 USD
	$319,423,904 PPP	$60,742 PPP	$1,801,350,880 PPP
Total	SR2,383,901,942	SR453,325	SR13,491,463,153
	$635,707,185 USD	$120,887 USD	$3,597,723,508 USD
	$1,548,994,114 PPP	$294,558 PPP	$8,766,382,815 PPP

Description of cost categories: Hospital includes the costs related to personnel, capital, and food throughout the hospital stay. Surgical includes costs of operating rooms, surgeon fees, and implants for hip fracture surgery specifically. Testing includes costs of radiographs, blood, and urine investigations. Prescription drugs include average cost of medications throughout hospital stay.

Figure 2. One-way sensitivity analyses for the estimated economic burden of osteoporosis in Saudi Arabia (2019). Abbreviation. SR, Saudi Riyal. 3.75 Saudi Riyal = 1 United States dollar. The tornado diagram displays the difference in one-year burden when comparing the results of the sensitivity analyses to the results of the base case analysis. ^a ± 13.08 days of base case value. Based on standard deviation in Sadat-Ali et al.⁸ The hospital lengths of stay for vertebral, wrist, and other fractures were varied in proportion to the change in hip fracture. ^b ± 33% (proportion of base case value). Range informed by Siggeirsdottir et al.^{43 c}Assumption informed by expert opinion. ^d ± 67% (proportion of base case value). Range informed by expert opinion. ^e ± 50% (proportion of base case value). Upper bound informed by Sadat-Ali et al.⁸ Note, additional details of cost breakdown were supplied by the authors.

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