We are thrilled to announce a pivotal collaboration between the Asia Pacific Consortium on Osteoporosis (APCO) and the South Asian Federation of Endocrine Societies (SAFES). This partnership underscores our shared commitment to advancing osteoporosis care and endocrinology research in the South Asian region. Together, we aim to address critical challenges in managing osteoporosis and reducing fracture risks through two transformative projects.

The MOU for this Collaboration was signed on 25 November 2024 by Prof Manju Chandran, Director and Senior Consultant, Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore and Clinical Professor, DUKE NUS Medical School, and Chairperson, APCO and Prof Rakesh Sahay, Professor of Endocrinology, Osmania Medical College, Hyderabad, India, and President of the SAFES.

The projects will be led by Prof Manju Chandran who is also a Board Member and Steering Committee Member of the Capture the Fracture (CTF) Governance of the International Osteoporosis Foundation (IOF), and APCO and SAFES member Dr Lakshmi Nagendra, Associate Professor, Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India. Dr Mickael Hiligsmann, Associate Professor in Health Economics, at Maastricht University, the Netherlands, will be the Honorary Consultant on this collaborative project.

Project 1: Cost-Effectiveness Study of Osteoporosis Treatment Thresholds in SAFES Countries

Background: Osteoporosis is a major global health issue, especially in SAFES countries with rapidly ageing populations. The Fracture Risk Assessment Tool (FRAX), though with some limitations, has become a valuable method for assessing fracture risk and guiding treatment. Evaluating the economic value of intervention thresholds for osteoporosis is crucial for policymakers before implementing recommendations.

Objective: Conduct a comprehensive cost-effectiveness study to evaluate the implementation of FRAX-based osteoporosis treatment thresholds in SAFES countries, including at least India, Bangladesh, Nepal, Sri Lanka and Pakistan.

Goal: The goal is to assess whether adopting FRAX-based treatment thresholds is a cost-effective strategy for managing osteoporosis in SAFES countries, taking into account both clinical outcomes and economic impact.

Project 2: The Cost-effectiveness Analysis of Fracture Liaison Services in SAFES Countries.

Background: Fractures are a significant health and economic burden worldwide, especially in resource-limited South Asian countries. Patients with recent fractures face a high risk of subsequent fractures, and Fracture Liaison Services (FLS) have been effective in reducing this risk and improving outcomes. However, FLS implementation in SAFES countries remains limited. This project aims to evaluate the cost-effectiveness of FLS in SAFES countries, identify barriers and facilitators, and provide evidence-based recommendations for healthcare policy and resource allocation.

Objectives:

• Assess the cost-effectiveness of implementing FLS in SAFES countries compared to standard fracture care practices.
• Identify barriers and facilitators to FLS implementation in SAFES countries, including cultural, economic, and infrastructural factors.
• Provide evidence-based recommendations for optimizing the implementation of FLS in SAFES countries to maximize cost-effectiveness and healthcare outcomes

Target Goal: The goal is to determine whether implementing FLS is cost-effective in SAFES countries and to identify barriers and facilitators to their implementation to specific provide recommendations that policymakers and clinicians can apply.

The projects will commence in December 2024 and are expected to be completed by November 2026. The projects will improve early diagnosis and management of osteoporosis and related fractures while providing cost-effective healthcare strategies tailored to the socio-economic landscape of South Asia. We are proud to partner with SAFES on these critical projects and are confident that this collaboration will leave a lasting impact on osteoporosis management in South Asia.

Stay tuned as we embark on this journey to revolutionize osteoporosis care in South Asia. Follow us for new updates and embark on this transformative healthcare initiative. Together, we can build a healthier future.