OBJECTIVE: Describes fragility fractures in the country taking into account the prevalence of the disease and appraisal of health care costs. METHODS: Epidemiological and costs data were obtained from secondary sources. Female patients °Ý50 years with fractures of the hip, spine and distal radius was considered as the surrogate variable for fragility fractures. The Philippine Health Insurance Corporation database, where a total of 4670 records of patients with reported spine fractures (11.7%, 545), distal radius (48.8%, 2280) and hip (39.5%, 1845) were considered in the estimation of the prevalence of osteoporosis in 2004. Costs inputs were obtained from randomly selected patients accounting records from health facilities nationwide. Direct costs include in-patient services and material costs. The National Pension Fund (NPF) database provided data on indirect costs covering present and future production losses resulting from premature death, morbidity or disability caused by the disease provided figures on sickness reimbursements, disability claims and death benefits. RESULTS: Prevalence estimates relative to the total female population according to age and fragility fracture involving the spine, lower end of radius and hip, showed 41%, with lower limit of 39.6 and upper limit of 42.5 (SE=0.7). The prevalence proportion for all age group is 67.9 for hip, 43.5 for spine and 18.7 for distal radius. Cost valuation was done for hip fractures, as it is most severe and best documented. The NPF paid a minimum of 120 days and maximum of 240 days for sickness reimbursements, an average of 35 months for disability claims and lifetime pension for primary beneficiary for premature deaths. CONCLUSIONS: Osteoporosis-related fractures are significant public health problems that require a more elaborate cost valuation assessment. Costs are significantly affected by government subsidy, monopoly of services and cross subsidization. A sensitivity analysis is needed for extrapolating costs estimates to the entire population.