News Release

Major milestone for secondary fracture prevention announced in Japan

The International Osteoporosis Foundation (IOF) welcomes the updated Fracture Liaison Service reimbursement scheme in Japan, which will serve to improve post-fracture care and decrease the burden of fragility fractures in Japan’s older population

Business Announcement

International Osteoporosis Foundation

An estimated 13 million people are living with osteoporosis in Japan.1 The bone disorder results in painful and disabling fragility fractures, often leading to long-term loss of mobility and independence in older adults.

Despite the immense burden of fragility fractures, an estimated 80% of the annual 200,000 patients who experience a hip fracture due to osteoporosis in Japan don’t get treatment for osteoporosis. In addition, the one-year continuation rate of osteoporosis medications after a hip fracture is only about 20%.3 In order to address this significant care gap, the Japanese Fracture Liaison Services (FLS) reimbursement scheme has been updated as of April 1st, 2022. The reimbursement scheme will provide major improvements to post-fracture patient care and the prevention of secondary fractures. By covering the evaluation for continuous secondary fracture prevention, it will ensure that patients who have suffered a hip fracture will be automatically assessed for osteoporosis and given necessary treatment, in line with FLS clinical standards and osteoporosis treatment guidelines from relevant academic societies.

Professor Takeshi Sawaguchi, the president of Fragility Fracture Network Japan (FFN-J) stated: 

"Secondary fracture prevention is essential in that an initial fracture greatly increases the risk of dangerous recurring fractures. A Japanese study showed that compared to the general population, women aged 65 years of age and over who sustain an initial hip fracture are four times as likely to sustain an additional hip fracture."3

Hip fractures are the most serious and life-threatening of osteoporosis-related fractures, resulting in a profound loss of function and independence among survivors. Approximately 33% of patients require nursing care in the year following the fracture.2

Professor Naoto Endo, the president of Japan Osteoporosis Society (JOS), added:

“The key to effective post-fracture care and secondary fracture prevention is the implementation of Fracture Liaison Services (FLS) in all hospitals that treat fracture patients. Such multidisciplinary, coordinator-based services help ensure that after an initial fracture patients are appropriately diagnosed, treated, and monitored to prevent recurring fractures. We applaud the new FLS reimbursement scheme which will be of immense benefit to the well-being of our hip fracture patients.”

Through its Capture the Fracture® (CTF) program, IOF advocates for and supports the establishment of FLS in the Asia Pacific and around the world. CTF currently comprises a network of 737 FLS in 50 countries, including 46 in Japan, and a total of 148 in the Asia Pacific region. As well, IOF works closely in collaboration with other medical and advocacy organizations in the region to support secondary fracture prevention initiatives. 

Professor Cyrus Cooper, president of IOF and founder of the Capture the Fracture® program, welcomed the updated Japanese FLS reimbursement scheme and emphasized the importance of supporting FLS development in Japan and the region as a whole. He stated:

“This development will help ensure that fracture patients receive better post-fracture care, leading to improved patient outcomes and reducing the risk of secondary fractures. These advances are urgently needed given that Japan has one of the longest life expectancy rates in the world, with 37% of the population projected to be aged 60 or older by 2050.”4

“The fragility fracture treatment gap is a global problem. We urge other countries in the Asia Pacific region and around the world to take note of the improvements in Japan. By strengthening the delivery of post-fracture care through the implementation of Fracture Liaison Services within their health care systems, all countries can act to improve the well-being and independence of their older populations.”



1.  The Japanese guideline of osteoporosis treatment & prevention 2015
2.  International Osteoporosis Foundation.… Accessed 11.04.22
3.  Hagino H, Sawaguchi T, Endo N, et al: The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90: 14-21, 2012
4.  Population projections for Japan, 2001-2050, The National Institute of Population and Social Security Research, 2002.

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 members, including committees of scientific researchers as well as more than 300 patient, medical and research organizations, work together to make fracture prevention and healthy mobility a worldwide heath care priority.   @iofbonehealth

About Capture the Fracture®

Capture the Fracture® (CTF) is a multi-stakeholder initiative, led by the International Osteoporosis Foundation (IOF), to facilitate the implementation of Post-Fracture Care (PFC) Coordination Programs, such as Fracture Liaison Services (FLS), for secondary fracture prevention. The CTF initiative, now celebrating its 10th year of service, aims to drive changes at local and regional levels to prioritize secondary fracture prevention. It sets global best practice standards and offers recognition for Fracture Liaison Services (FLS) through its Best Practice Framework. CTF also provides essential resources and documentation to build the case for prioritization of secondary fracture prevention and to help drive the implementation and quality improvement of FLS. Mentorship programs that support the development of FLS at the local level are also offered. 

Currently, the CTF network includes 737 FLS in 50 countries worldwide. FLS are invited to apply for free assessment and recognition via the CTF website’s online Best Practice Framework application platform.    #CaptureTheFracture

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