Archives of Osteoporosis · Oct 31, 2026

Cost saving strategies for management of postmenopausal women with fragility fractures in Taiwan: a simulation projection model from 2025 to 2045

By Huang ST, Lai HY, Wang CY et al.

This study used a microsimulation model to assess the impact of improved osteoporosis diagnosis, treatment, and adherence in Taiwan. The combined approach prevented 42,605 fractures and saved NT$4.64 billion by 2045. The results emphasize the importance of comprehensive anti-osteoporosis management in evidence-based healthcare policy. Introduction Taiwan’s rapidly aging population presents mounting challenges for osteoporosis management, with healthcare resources increasingly constrained under the National Health Insurance system. This study projected the clinical and economic impact of enhanced osteoporosis diagnosis, treatment, and adherence strategies among postmenopausal women in Taiwan from 2025 to 2045. Methods A cross-sectional microsimulation model projected annual osteoporotic fracture incidence and costs among postmenopausal women aged ≥65 years. Fracture risk was estimated using simplified Fracture Risk Assessment Tool (FRAX), with inputs from published literature and national health insurance data informing demographic distribution, treatment patterns, and healthcare costs. Three scenarios evaluated: (1) improved medication adherence alone, (2) increased case finding through enhanced screening and treatment rates, and (3) combined case finding and adherence improvements. Results In the reference scenario, the annual number of osteoporotic fractures are projected to increase by 99% from 137,557 in 2025 to 273,820 in 2045, with annual costs rising from NT$20.10 billion to NT$39.32 billion. Enhanced case finding prevented 12,061 fractures and saved NT$1.21 billion in 2025, escalating to 23,983 prevented fractures and NT$2.49 billion saved by 2045. Improved adherence alone prevented 14,853 fractures (NT$1.57 billion saved) in 2025, increasing to 22,525 fractures (NT$2.33 billion saved) by 2045. The combined approach demonstrated superior outcomes, preventing 22,045 fractures (NT$2.32 billion saved) in 2025 and 42,605 fractures (NT$4.64 billion saved) by 2045. Conclusion Comprehensive osteoporosis management strategies incorporating enhanced case finding and improved adherence will substantially reduce clinical and economic burden in Taiwan’s aging population over the next two decades, supporting evidence-based healthcare policy development.

doi.org/10.1007/s11657-026-01789-4PubMed 42965757Interventions