image: The International Osteoporosis Foundation (IOF) and the Asia Pacific Consortium on Osteoporosis (APCO) have today launched The APCO-IOF Asia Pacific Regional Audit: Epidemiology, Costs and Burden of Osteoporosis In 2025 at the IOF 9th Asia Pacific Bone Health Conference in Tokyo. This key report presents the most comprehensive assessment to date of the burden of osteoporosis and fragility fractures across 22 countries and regions, revealing both the magnitude of the challenge and the opportunities for timely, collaborative action.
Credit: International Osteoporosis Foundation (IOF)
The International Osteoporosis Foundation (IOF) and the Asia Pacific Consortium on Osteoporosis (APCO) have today launched The APCO-IOF Asia Pacific Regional Audit: Epidemiology, Costs and Burden of Osteoporosis In 2025 at the IOF 9th Asia Pacific Bone Health Conference in Tokyo.
This key report presents the most comprehensive assessment to date of the burden of osteoporosis and fragility fractures across 22 countries and regions, revealing both the magnitude of the challenge and the opportunities for timely, collaborative action.
A region at a demographic crossroads
The Audit underscores that the Asia Pacific region is undergoing a profound demographic shift - by 2075, the region will be home to nearly half the world’s population, with average life expectancy rising from 78 to 87 years. Osteoporosis and related fragility fractures affect the older population, and globally, around one in three women and one in five men aged 50 and over will sustain a fragility fracture in their remaining lifetimes. The proportion of people aged 50+ years is set to increase across every country and region included in the Audit. By 2075, more than half the total population is projected to be 50+ years in China (55%), Chinese Taipei (59%), Hong Kong SAR (55%), Japan (57%), the Republic of Korea (61%), Singapore (51%), and Thailand (52%).
“The Asia Pacific’s demographic transformation underlines the urgency for action,” said Professor Manju Chandran, Senior Consultant and Director of the Osteoporosis and Bone Metabolism Unit, Department of Endocrinology at Singapore General Hospital and Chairperson of APCO. “Osteoporosis-related fractures are a major cause of disability, loss of independence and early death and they cause enormous costs to healthcare systems and communities. We must act now to ensure that longer lives are also healthier, independent lives, and that our health systems can meet the needs of ageing populations.”
Across the region, poor bone health and the ageing population is driving a steep rise in fracture rates. Just a few examples: in China, osteoporosis affects nearly one-third of adults over 65, and the number of fragility fractures is expected to climb further as the population ages. In Malaysia, hip fractures are projected to rise more than three-fold by 2050, while Australia anticipates more than 2.1 million fragility fractures over the next decade. Collectively, these trends signal an intensifying bone-health burden across the Asia–Pacific.
Disparities in progress and emerging gaps identified
While some countries have made significant advances in bone health policy and care delivery, the Audit reveals wide disparities across the region as well as gaps in data and research:
- Fracture data systems: Only 10 of 22 countries and regions maintain centralized databases, and fewer still capture all fracture types.
- Models of care: Osteoporosis is managed predominantly by orthopaedic surgeons. Fracture Liaison Services (FLS) are limited; one-quarter of countries have none, and in over half, fewer than 25% of hospitals are covered. Only New Zealand and Singapore achieve coverage above 50%. Access to diagnostics and treatment: DXA scan wait times range from same-day to nearly one year, with costs varying between USD 15 and 175.
- Reimbursement gaps limit the affordability of treatment in many settings. Newer anabolic agents are only available in a few settings, and rarely reimbursed. In many settings, fewer than half of patients recommended for therapy actually initiate it.
- Clinical guidelines: Although 16 countries have published guidelines, only a handful have national quality standards to benchmark and monitor progress.
- Policy environment: Just six countries have designated osteoporosis as a national health priority, and patient advocacy organizations are active in only nine.
Ten urgent priorities to drive fracture prevention and improved patient outcomes
To address the challenges identified in the Audit, the authors of the Audit outline a roadmap of ten priorities:
- Designate osteoporosis as a national health priority.
- Establish and expand national fracture registries, beginning with hip fracture as a sentinel event.
- Ensure universal access to best-practice in post-fracture care, including through Fracture Liaison and Orthogeriatric Services.
- Promote life-course interventions in nutrition and exercise.
- Strengthen professional education for osteoporosis specialists, orthopaedic surgeons and primary care providers.
- Implement routine fracture-risk assessment in primary care for adults aged 50+.
- Integrate osteoporosis management into prescribing of bone-wasting medications.
- Institute public awareness campaigns to empower individuals to assess and manage their fracture risk.
- Create national alliances for falls and fragility-fracture prevention.
- Scale innovative models such as AI, digital tools, telehealth, and integrated data systems to improve fracture prevention.
IOF President Professor Nicholas Harvey, Director of the MRC Lifecourse Epidemiology Centre and Professor of Rheumatology and Clinical Epidemiology, University of Southampton, UK, highlighted: “The APCO-IOF Asia Pacific Regional Audit is presented as both a benchmark and a Call to Action. It emphasizes that the solutions needed are already proven, and achievable through collaboration among governments, healthcare professionals, patient societies, and the private sector.”
“If we act decisively before demographic pressures peak, we can change the trajectory of bone health across the region, ensuring that longevity is accompanied by healthy mobility and independence.”
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About the Audit
The APCO-IOF Asia Pacific Regional Audit: Epidemiology, Costs and Burden of Osteoporosis in 2025 was jointly developed by the International Osteoporosis Foundation (IOF) and the Asia Pacific Consortium on Osteoporosis (APCO). It assesses the current burden of osteoporosis and fragility fractures, healthcare responses, and policy environments across 22 Asia Pacific countries and regions, and provides a framework for strengthening bone health strategies in the coming decades.
View the report and related resources here: https://www.osteoporosis.foundation/asia-pacific-audit-2025
About IOF
The International Osteoporosis Foundation (IOF) is the world’s largest nongovernmental organization dedicated to the prevention, diagnosis, and treatment of osteoporosis and related musculoskeletal diseases. IOF’s membership committees include leading scientific experts, 340 patient organizations and medical societies in more than 150 countries, as well as universities worldwide. The IOF Capture the Fracture® initiative counts over 1,200 Fracture Liaison Services across all regions of the world. Together, this global network works to prioritize bone health and fracture prevention, sharing a vision of a world free from fragility fractures, where healthy mobility is a reality for all. @iofbonehealth www.osteoporosis.foundation
About APCO
The Asia Pacific Consortium on Osteoporosis (APCO) is a multidisciplinary network
of leading experts spanning the breadth of the Asia Pacific region, committed to developing unified clinical frameworks that standardize osteoporosis screening, diagnosis, and management. APCO’s mission is to engage with relevant stakeholders, including healthcare providers, policy makers and the public, to help develop and implement country and region-specific programs for the prevention and treatment of osteoporosis and its complication of fragility fractures in the Asia Pacific.
https://apcobonehealth.org/