In April 2022, a new reimbursement scheme for the Japanese Fracture Liaison Service was implemented in Japan for patients who have sustained a fragility hip fracture. The reimbursement scheme has been designed to improve post-fracture patient care and increase access to the prevention of secondary fractures. 

The new scheme covers the evaluation for secondary fracture prevention throughout care. This approach will ensure that patients who have suffered a hip fracture will be automatically assessed for osteoporosis and given the necessary treatment which aligns with international guidelines and FLS clinical standards.

Since last April, extensive work has been undertaken by FFN Japan to register hospitals on the Japan Hip Fracture Registry so that there is a system to track hospital performance. There has also been the development of educational tools.

There are an estimated 13 million people living with osteoporosis in Japan and 240,000 patients annually who experience a hip fracture due to osteoporosis. Many patients don’t get the treatment they need at the time of the fracture. This further deteriorates as they return home with only about 20% still being on medication one year later. Osteoporosis is a bone disorder that results in painful and disabling fragility fractures, often leading to long-term loss of mobility and independence in older adults.

Professor Takeshi Sawaguchi, the president of Fragility Fracture Network Japan (FFN-J) stated: "Japan has one of the longest life expectancies which over the next few years will create a burden on the health care system. We know that one hip fracture is a risk factor for a second fracture, so prevention is essential. 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."

The gap in the management of fragility fracture treatment is a problem around the globe. FFN understands that implementing best practices requires changes at both a clinical and a policy level. Japan, through the leadership of FFN Japan, has shown what can be achieved by working together.

At FFN, we will learn from the successes of the project and share relevant information with colleagues around the world so that we can improve the care of patients with fragility fractures.