The State of
Bone Health
Annual Report
The definitive annual benchmark on clinical practice, market dynamics, treatment gaps, infrastructure investment, and economic burden across the bone health field. Built for clinicians, payers, industry, and investors.
osteoporosis or low bone density
cost burden
never subsequently treated
in coordinated FLS care
About the Report
The field's most persistent problems are structural, not scientific.
The clinical science of bone health is mature. The tools to identify fracture risk exist. Effective treatments are approved and available. What is missing is the systematic infrastructure to deploy them — and the independent data to measure why.
The BHM Annual Report exists to fill that gap. Each edition benchmarks where the field stands, identifies what is working, and makes the economic and clinical case for change. It is the data layer that connects analysis to action.
Notify Me When PublishedWhat the Report Covers
Report Structure
What's Inside the 2026 Report
The State of the Field
A high-level synthesis of where bone health stands in 2026 — the treatment gap, the infrastructure deficit, the economic stakes, and the key inflection points shaping the year ahead.
Screening, Diagnosis & Treatment Rates
Who is being screened, who is being treated, and what the gaps reveal about the structural barriers between evidence-based guidelines and clinical reality.
The PBM–Risk Pool Disconnect
How pharmacy benefit management incentives diverge from risk pool economics — and why the calculus of fracture prevention rarely reaches the decision-makers who can change it.
FLS Deployment & Coordinator Capacity
The state of fracture liaison services in the U.S. — where they exist, where they don't, what they cost to build, and what they save when they run well.
Fracture Cost & Prevention ROI
Hip fracture hospitalization costs. Vertebral fracture downstream utilization. Long-term care transition rates. The actuarial case for infrastructure investment over fracture cost avoidance.
The Capital-Infrastructure Connection
Where investment is moving, what infrastructure gaps remain capital-ready, and the indicators that will define whether 2026 becomes an inflection point for the field.
From the 2026 Report
The Lifespan
Fracture Risk
Framework
Risk identification can begin at age 40. Intervention before first fracture is the highest-value point in the continuum. The infrastructure to do this exists in clinical science. What is missing is systematic deployment at scale.
The 2026 report provides the first comprehensive benchmarking of where this infrastructure exists, where it doesn't, and what the gap costs the healthcare system annually.
Access the Full Report| Age | Stage | Infrastructure Need |
|---|---|---|
| 40–49 | Early bone loss | Baseline DXA in high-risk subgroups; FRAX® baseline |
| 50–59 | Perimenopause transition | Systematic DXA screening; secondary cause workup |
| 60–69 | Osteopenia / osteoporosis | Treatment initiation; coordinator-supported management |
| 70–79 | Peak fracture risk decade | Fall prevention integration; vertebral fracture assessment |
| 80+ | End-of-life prevention | Fracture liaison services; post-fracture coordination |
Related Research
BHM Working Paper Series
Unlocking Refrigerated Capital
A Structural Investment Reset for Bone Health
Where the capital is frozen, what is preventing it from flowing toward infrastructure, and how to unlock it. The economic architecture of the bone health investment problem — and the framework for solving it.
Read the Paper →The Fracture-to-Death Continuum
A Lifespan Infrastructure Framework
What that capital should build — a systematic, lifespan-spanning infrastructure for identifying and reducing fracture risk from age 40 to end of life, with healthcare savings as the explicit measure of success.
Read the Paper →Be first to access
the 2026 Report.
The BHM Annual Report publishes in Fall 2026. Register below to be notified on release day.
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