Health economic evaluation for osteoporosis suffers from methodological limitations. For example, osteoporosis results in various types of fractures each with different impact on patients. Another example is that some therapeutic drugs have extraskeletal benefits and adverse events. Osteoporosis and resultant fracture has profound effects on patients' life expectancy and quality of life, which, however, is not well understood. To promote the health economic evaluation for osteoporosis is our urgent research project in Japan.