A fresh approach is needed to preventing fractures among the elderly, with more effort put into reducing the number of falls, experts say.
A Finnish team said many health systems placed too much emphasis on treating the bone disease osteoporosis, for which drug treatment can be expensive.
They said measures such as home safety improvements could have a huge impact.
GPs agreed with the recommendations, but osteoporosis campaigners said an integrated approach was needed.
One in three people over the age of 65 is harmed in a fall each year in England, with a third of those who suffer fracture having a DXA scan, which measures bone density.
"Doctors identify illness and treat them with drugs. It is the medical model"
But the experts from Tampere University, who analysed previous research on the topic from across the developed world, said such screening was often inaccurate.
They said falling was the major cause of nine in 10 hip fractures.
The researchers calculated that to avert one fracture a year, 577 post-menopausal women would have to be treated with osteoporosis drugs at a combined cost of £120,000.
Among the over-80s high-risk group, prevention of hip fracture would still cost £28,500 with drug treatment.
The researchers said GPs should be identifying at-risk individuals and assessing their needs.
Measures such as strength and balance training, vitamin supplements and home safety improvements can cut the risk of falls by 50%, they added.
Issues
Lead researcher Teppo Jarvinen said: "The first thing we must do is prioritise and not deal with minor issues when we have not dealt with major issues.
"No matter how effective osteoporosis screening and treatment is, three-quarters of those people who have fractures have not got osteoporosis."
Dr Maureen Baker, of the UK's Royal College of GPs, agreed there needed to be more emphasis on falls prevention.
"Doctors identify illness and treat them with drugs. It is the medical model."
But Julia Thompson, of the National Osteoporosis Society, said falls prevention did not reduce the risk of things such as spinal fractures.
"Osteoporosis treatment has to go hand-in-hand with falls prevention to help the hundreds of thousands of people in the UK at risk of breaking a bone."
The Department of Health said ministers recognised "more action needed to be taken" on falls prevention.
A spokeswoman added the Royal College of Physicians had been asked to carry out an audit of falls services and improvements would be made.
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