Postmenopausal Osteoporosis Market Size & Share Analysis - Growth Trends & Forecasts (2025 - 2030)

Global Postmenopausal Osteoporosis Market Trends and Insights

Growing Ageing Female Population Base

The number of women aged 50 years and older is projected to climb 30% globally by 2030, driving first-line screening and therapy use. Recent studies in China reveal significant regional variations, with Shanghai reporting osteoporosis prevalence of 12.5% among middle-aged adults, while Sichuan Province demonstrates 19.42% overall prevalence, with 32.1% of postmenopausal women and 6.9% of men over 50 affected. Longer life expectancy positions high-risk women for extended pharmacologic exposure, increasing demand for agents with proven fracture-risk reduction. Consequently, manufacturers are prioritising once-yearly or biannual dosing regimens to align with geriatric adherence needs.

Fracture-Cost Containment Programs by Insurers

US and EU payers intensify post-fracture programs after economic analyses show that treating high-risk patients early saves direct medical costs compared with managing subsequent fractures. Mexican modelling demonstrated that romosozumab can reduce lifetime costs by USD 51,363 per patient while improving outcomes relative to teriparatide. Belgium followed with favourable health-economic findings supporting reimbursement for anabolic treatment in very high-risk postmenopausal women. Insurers therefore steer formularies toward injectable therapies showing 92.5% adherence versus 63.5% for oral alendronate.

Bisphosphonate Patent Expiries Boosting Generics

Alendronate, risedronate and ibandronate lost exclusivity in major markets, and generic uptake now exceeds 80% of prescriptions in many EU states, lowering annual therapy cost by up to 70%. Lower prices widen access in emerging economies, prompting guidelines to favour initiating generics when fracture risk is moderate. This generic shift also frees payer budgets to fund premium anabolic agents for very high-risk patients. Manufacturers respond through reformulated weekly or monthly tablets to defend brand loyalty. Digital reminder apps bundled with generics aim to curb the 35% discontinuation observed during the first treatment year.

Launch of Anabolic Agents with Superior BMD Efficacy

Romosozumab’s dual mechanism yields 73% relative reduction in new vertebral fractures versus placebo, reshaping osteoporosis treatment sequences. The 2024 ASBMR/BHOF guidance now recommends anabolic-first therapy in very high-risk patients before antiresorptive maintenance. NICE’s 2024 green light for abaloparatide opened NHS reimbursement to 14,000 women deemed at imminent fracture risk. Real-world satisfaction tops 86% among abaloparatide users, with 83% adherence at 12 months, reinforcing payer confidence. Sequential protocols combining 12 months of anabolic therapy followed by denosumab are moving into mainstream clinical routines.

Safety Concerns around Long-Term Bisphosphonate Use

Emerging evidence links extended bisphosphonate courses with atypical femoral fractures and osteonecrosis of the jaw, prompting clinicians to opt for drug holidays after 3–5 years. Awareness campaigns in the US and EU shifted 12-month persistence from 54% in 2020 to 47% in 2024 as cautious patients discontinued therapy, dampening sales. Regulatory agencies now require class-wide labelling updates describing rare fracture risks. These safety dialogues accelerate physician adoption of injectables that deliver comparable or superior BMD gains without prolonged skeletal retention. Nevertheless, payers weigh the higher acquisition cost of biologics against long-term fracture avoidance benefits.

Declining DXA Scanner Reimbursement in Europe

Cuts in national tariffs have forced many private radiology centres to retire DXA services, stretching wait times for bone density tests beyond 6 months in parts of Italy and Spain. Hospital-based scanners absorb overflow but create scheduling bottlenecks. Limited diagnostic capacity delays therapy initiation, especially in rural settings. Policymakers consider boosting tariffs or funding mobile DXA units to prevent missed fracture-prevention opportunities. AI-driven CT opportunistic screening is a potential workaround, yet payers remain cautious about reimbursement until large-scale validation confirms cost-effectiveness.

Segment Analysis

By Drug Class: Biosimilar Competition Reshapes Market Leadership

Bisphosphonates commanded 47.15% of the osteoporosis drugs market share in 2024, buoyed by decades of clinician familiarity and low pricing. However, the osteoporosis drugs market size for RANKL inhibitors is projected to expand as biosimilar denosumab variants roll out worldwide. Sandoz introduced Wyost and Jubbonti in May 2025 in the US, and Samsung Bioepis, Celltrion and Teva will follow through 2026. First-to-market biosimilars launched at price discounts of 20-30%, accelerating adoption in cost-sensitive health systems.

Sequential anabolic-antiresorptive therapy is becoming standard in very high-risk cohorts, sustaining demand for both classes. Parathyroid hormone analogs gain renewed momentum after NICE endorsed abaloparatide, and experts predict double-digit uptake in Europe once reimbursement cascades through other markets. SERMs and calcitonin maintain niche usage among patients contra-indicated for frontline agents. Generic pipelines remain active across all small-molecule classes, and reformulation strategies such as effervescent tablets aim to retain market share against low-cost copies. Overall, innovation and biosimilar economics intertwine to create a two-tier competitive field where value-based pricing dominates purchasing.

Note: Segment shares of all individual segments available upon report purchase

By Route of Administration: Injectable Therapies Gain Preference

Oral options still accounted for 60.85% of the osteoporosis drugs market size in 2024, driven by weekly or monthly bisphosphonate dosing and mature generic lines. Yet subcutaneous agents are on track for a 6.1% CAGR through 2030 as patients and providers gravitate toward biannual injections such as denosumab or monthly romosozumab. Randomised trials confirm superior femoral-neck BMD gains with denosumab versus alendronate, fuelling confidence in biologic delivery routes. Patient-reported studies show that 88% of elderly users prefer at-home injection devices over clinic-based infusions.

Intravenous zoledronic acid retains a role for those seeking annual dosing convenience, with pivotal studies documenting 70% spinal-fracture risk reduction. Wearable ultrasound device Osteoboost became the first non-pharmacologic prescription option cleared by FDA in May 2025, signalling technology’s capacity to complement pharmacotherapy. Digital adherence add-ons integrated into autoinjectors now transmit dosing confirmation to cloud dashboards, lifting 12-month persistence rates from 65% to 92% in pilot cohorts. Collectively, delivery innovation aligns with the broader trend toward personalising therapy according to fracture risk and lifestyle practicality

By Distribution Channel: Digital Transformation Accelerates Online Growth

Hospital pharmacies generated 53.05% of global revenue in 2024 because injectable biologics require cold-chain management and nurse-led counselling. Integrated Fracture Liaison Services inside hospitals further reinforce this channel by linking post-fracture patients to immediate therapy initiation. Online outlets achieved the fastest 5.76% CAGR projection as pandemic-era habits normalised mail-order fulfilment and digital refill reminders. Retail chains still command a meaningful footprint but feel price pressure from internet competitors offering auto-ship discounts and telepharmacy support.

Payers increasingly contract directly with specialty pharmacies for biosimilar denosumab, bundling medication with virtual adherence coaching to maximise cost savings. In emerging markets, e-commerce pharmacy apps are bridging geographic gaps by delivering generics to underserved rural zones within 48 hours. Regulatory agencies tighten oversight of online sales to reduce counterfeit risk, mandating track-and-trace serialisation for biologics. Overall, distribution evolves toward omnichannel models that place patient convenience and data-driven adherence at the centre of commercial strategy.

Note: Segment shares of all individual segments available upon report purchase

Geography Analysis

North America captured 37.70% of 2024 revenue for the osteoporosis drugs market. Broad insurance coverage and rapid adoption of novel agents underpin leadership, while the FDA’s clearance of digital therapeutic Osteoboost exemplifies the region’s openness to breakthrough solutions. Biosimilar pressure escalates after February 2025, yet Amgen’s Prolia still posted 10% sales growth in Q1 2025 pre-erosion, signalling resilience through brand loyalty programs. Policy moves such as CMS removing prior-authorisation hurdles on select bone stimulators further smooth treatment pathways .

Europe shows steady, value-driven uptake of biosimilars after EMA approvals of Wyost, Jubbonti, Stoboclo and Osenvelt through 2024-2025. NICE’s economic endorsement of abaloparatide in England set a precedent for wider EU funding, covering 14,000 high-risk women in its first year. Nonetheless, shrinking DXA reimbursement narrows diagnostic capacity, prompting Italian experts to petition AIFA for algorithm-based fracture-risk assessment upgrades. Health ministries weigh mobile scanning vans and AI-enhanced CT analytics to mitigate bottlenecks.

Asia-Pacific posts the fastest 6.73% CAGR as shifting demographics swell the patient base; prevalence already affects up to 30% of women over 40 in developed regional economies. Multinationals pursue local licensing; Radius granted Pharmanovia rights to abaloparatide for China and ASEAN markets in March 2025, aiming to leverage escalating fracture rates. Regional guidelines increasingly acknowledge ethnicity-specific BMD norms to prevent misclassification, highlighting the need for device calibration research.