A new study into bone fractures due to osteoporosis has found the majority of people who are at very high-risk are not receiving treatment for the condition.
The finding was made by academics and clinicians at University of Galway.
They are calling for a new national osteoporosis strategy.
The cases of more than 5,000 men and women, who were referred to the University Hospital Galway Osteoporosis service, were analysed as part of the study.
Osteoporosis is a disease that weakens bones, commonly known as brittle bones disease.
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The university's researchers said the results of the study, released to coincide with World Osteoporosis Day, reveal the "scale of over-treatment of people at low-risk of osteoporosis and under-treatment of those most in need of medication".
The findings show 70% of men and 54% of women, who are at very high-risk of fracture, are not on treatment.
While an even greater proportion of men and women in the at-risk category, 80% and 70% respectively, are not taking appropriate treatment.
The researchers said Ireland does not have an osteoporosis clinical programme despite bone disease being one of the most prevalent and disabling conditions in the country.
It accounts for almost 10% of the healthcare budget.
The project, which was funded by the Health Research Board, was led by the clinical lead in Osteoporosis and Fracture Liaison Services at University Hospital Galway who said it has revealed the treatment gap is much larger than previous reports had suggested and in the region of 60% - 70%.
John Carey, a Professor in Medicine at University of Galway and Consultant Physician in Medicine and Rheumatology, said: "What's very concerning is there's a lot of people not on treatment who should be on treatment and there's a lot of people on treatment that probably has no benefit and that does have a cost and potentially is harmful.
"Unfortunately, without a national programme for osteoporosis, we're seeing many patients not being tested and not being treated who already have osteoporosis and are having multiple fractures, which are life threatening, life altering problems and a huge financial cost for them."
However, Mr Carey said that "on the other hand, we're seeing a lot of unnecessary over-testing and over-treating or treating with ineffective therapies for people who don't need it".
He believes a national osteoporosis programme would help to address the current anomalies.
"We're asking for a national programme to reduce the cost, to reduce the waste, to provide better quality for the people of Ireland," he said.
Mr Carey said: "A clinical programme where we could harmonise best practice, standards and guidelines, get the experts together, people like myself and we could help advise the minister and the Department of Health on how patients should be assessed, who should be assessed, how they should be managed and how they should not be managed.
"So we can provide the best care for our patients."
He said the study shows that "fractures are one of the commonest reasons to be admitted to an acute public hospital in Ireland and one of the greatest needs for beds in public hospitals".
"Our estimate is that around 10% of the healthcare budget today in Ireland is going to treat and manage these fractures, many of which are preventable with the tools and the treatments we have available today, which would save a lot of money," he said.
