Impacts of Medical Technology in Australia
Productivity Commission
Addendum to submission # 33
The concern over the restricted access of Fosamax to prevent bone fractures

Dear Commissioner Owens,

The Government rejected the submissions from drug companies to include bisphosphonate drugs in the PBS scheme because the submissions were incomplete and did not include:

1.	The need to also subsidize bone density test;
2.	The high cost of bone fractures (minor and major); and
3.	Who should have bone density test and at what age

I will go back to my original submission and state the importance of subsidizing bone density test ($75. 00) for all women between the ages of 45 – 50 so that bone fractures are prevented.  The reason why I stated the submission as tandem was because; prescription should follow confirmation of thinning bone (below -2 standard deviations).  Most importantly, neither the medical community nor the Government should wait for fractures.   

Cost of Preventive measures
	Per unit	Per Year	
Fosamax 70 mg 
(a weekly dosage)	
$14.00	
$728.00	

1.	Bone density test alone = $75.00

2.	Bone density test plus a weekly Fosamax prescription:
•	bone density test 			= $  75.00
•	annual Fosamax prescription 	= $728.00

1.	
3.	Cost of simple fractures:
Cost of X-ray
Cost of bone density test
Cost of Doctors fees
Cost of pain medications
Cost of loss of productivity
Cost of annual Fosamax prescription 

4.	Cost of multiple or hip fractures:
Cost of X-ray
Cost of bone density test
Cost of Doctors fees
Cost of pain medications
Cost of loss of productivity
Cost of annual Fosamax prescription 
Cost of ancillary services (could be permanent or temporary)
Permanent disability or death, which does not have monetary value

Respectfully submitted,

Enku Kebede-Francis, PhD
Visiting Fellow, the Medical School, Australian National University
6 June 2005