OBJECTIVE: Osteoporosis has little impact on mortality, but an important impact on health related quality of life (QOL), but few experimental data about QOL loss are available. The American National Osteoporosis Foundation (NOF) avoided this problem by using an expert panel. In this study a Dutch expert panel evaluated the same post-fracture conditions. METHODS: The NOF post-fracture conditions were evaluated by a panel using the time trade-off method. Total burden of illness was evaluated using a preexisting model fitted with Dutch fracture data, assuming increased mortality after hip fractures. In-hospital mortality directly after hip fractures in men and women was assumed to correspond to this increased mortality. RESULTS: The Dutch evaluations of QALY loss in the first and subsequent years after fracture were consistently lower than the US evaluations. Assuming average health pre-fracture the QALY loss due to hip fracture was estimated at 0.28 for the first year (0.47 in the NOF report) and at 0.12 for subsequent years (vs. 0.17). For wrist fracture this was 0.03 vs. 0.05 for first and 0.002 vs. 0.006 for subsequent years. For vertebral fractures this was 0.04 vs. 0.05 for first year and 0.02 vs. 0.05 for subsequent years. Average loss of life in the population due to osteoporosis in general was evaluated for women at 23 days. Average loss of health related QOL was evaluated at 0.33 QALY’s. For men this loss was estimated at 15 days and 0.13 QALY’s respectively. CONCLUSIONS: The Dutch estimates of health related QALY losses were lower than in the American evaluation. Wrist fractures have little impact on overall burden of illness, but the impact of vertebral fractures is proportionally higher than expected due to the long-term QOL effects. Although only 25 % of hip fractures occur in men the impact on mortality is proportionally higher.