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Monday, 10 October 1994
Page: 1381

(Question No. 1657)

Senator Knowles asked the Minister representing the Minister for Human Services and Health, upon notice, on 23 August 1994:

  (1) What is the cost to the community of osteoporosis, related injuries and treatment such as hip replacement.

  (2) Why is there no Medicare rebate for densitometry for women with a family history of osteoporosis who are known to be at high risk.

  (3) Does the Government intend to grant a Medicare rebate for these tests in the future; if so, to whom.

Senator Crowley —The Minister for Human Services and Health has provided the following answer to the honourable senator's question:

  (1) The significance of osteoporosis in Australia in terms of its incidence and costs was one of a range of issues considered by a workshop of osteoporosis experts convened by the Deputy Prime Minister and the then Minister for Health, Housing and Community Services, the Hon. Brian Howe MP, in August 1992. The workshop reviewed available data sources and concluded that it was difficult to estimate accurately the extent of osteoporosis in Australia because of the lack of comprehensive national data. It was agreed that osteoporosis could affect up to one in three Australian women and a smaller proportion of men. It was also noted that two community-based studies which are being conducted would provide more direct estimates of the incidence and costs of osteoporosis in Australia: namely, the Dubbo Osteoporosis Study and the Geelong Study.

  On the issue of the annual cost of osteoporosis to the Australian community, the workshop noted that this had been estimated as ranging from $200 million to $500 million.

  (2) The Medicare benefits arrangements for bone densitometry, which were introduced on 1 March 1994, follow the expert advice of the Medicare Benefits Advisory Committee (MBAC) on their specification and implementation. MBAC is an independent statutory body, comprising eight medical practitioners from a range of disciplines, which advises the Minister for Human Services and Health on the application of Medicare benefits to specified health services.

  In developing its advice, MBAC reviewed current scientific knowledge and clinical practice in regard to bone densitometry and consulted with experts in the osteoporosis and bone densitometry fields. MBAC recommended that the payment of Medicare benefits should be confined to two clinical applications of bone densitometry, with a series of measures to promote quality and appropriate use of the technology. These are, firstly, in the confirmation and monitoring of established osteoporosis and, secondly, in the diagnosis and monitoring of bone loss associated with a specific set of clinical conditions and/or treatments including, among others, rheumatoid arthritis and chronic renal disease. Two items have been included in the Medicare Benefits Schedule corresponding to these two recommended clinical applications.

  On the issue of the use of bone densitometry as a screening tool to detect developing osteoporosis, MBAC concluded that there was insufficient scientific evidence to warrant the payment of Medicare benefits for this purpose. However, women who are receiving hormone replacement therapy (HRT), or other treatments for osteoporosis, are eligible for Medicare benefits for bone densitometry as part of the monitoring of their condition.

  (3) In line with MBAC's recommendations, the Medicare benefit arrangements for bone densitometry will be reviewed twelve months after their introduction. The review will consider the current arrangements, new evidence on the clinical role of bone densitometry, and developments in bone densitometry technology.