Description of Medical ServiceMedicare Benefits Schedule (MBS) items 12320 and 12322 currently provide for bone densitometry, using dual energy X‑ray absorptiometry or quantitative computed tomography, in patients aged 70 years of age and over. Bone densitometry measures a patient’s bone mineral density (BMD) and compares the patient’s BMD with the average BMD of young healthy adults (called a T-score).
Description of Medical ConditionOsteoporosis is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than in normal bone. Diagnosis of osteoporosis requires an assessment of BMD. Patients with osteoporosis are defined as those with a T-score of -2.5 or lower.
Fractures due to osteoporosis (osteoporotic fractures) can lead to changes in posture, muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.
Patients aged 70 years or older with osteoporosis (defined as those with a BMD T-score of -2.5 or less) and without a history of minimal trauma fracture, can access osteoporosis medications listed on the Pharmaceutical Benefits Scheme (PBS) for primary prevention of fractures. The Pharmaceutical Benefits Advisory Committee (PBAC) has considered proposals to expand the current age restriction for PBS listed osteoporosis medicines for primary prevention of fractures to include patients aged 60 to 69 years. However, the PBAC deferred making a recommendation to amend the current age restriction for PBS listed osteoporosis medicines for primary prevention of fracture to include patients aged 60 to 69 years, pending a review of the MBS implications, to ensure that the bone densitometry MBS items could be aligned with the PBAC recommendations. See PBAC outcome for Osteoporosis Therapy Restrictions Review and Public Summary Document for Risedronic Acid (November 2022).
Reason for ApplicationThe application will assess the cost-effectiveness and total cost of amending the current age restriction for MBS items 12320 and 12322 to include patients aged 60 to 69 years to align with proposals to amend the age restriction for PBS listed osteoporosis medicines for primary prevention of fracture.
Medical Service TypeInvestigative, codependent technology
Previous Application Number/sNot Applicable
Consultation SurveyConsultation Survey (PDF 778 KB)
Consultation Survey (Word 36 KB)
Expedited – Bypassing PASC
MSAC consultation input must be received by no later than Friday, 16 February 2024 for it to be considered by MSAC at its April 2024 meeting.
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