GUEST POST BY DR. FAMIDA JIWA, President/CEO Osteoporosis Canada
British Columbia residents who have been diagnosed with osteoporosis or are at high risk of fracture are not treated fairly, relative to other jurisdictions. This was demonstrated in a report card published in a medical journal which included ratings in seven provinces – British Columbia, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick and Newfoundland.
Osteoporosis Canada is an advocacy organization that is trying to draw attention to the findings that show that B.C. is among the worst in Canada for access to treatments and bone mineral density testing.
Oral bisphosphonates medications are more easily accessible with fewer restrictions in all provinces except B.C. where a patient must have had a broken bone from osteoporosis to be eligible for reimbursement. Not being able to take an oral bisphosphonate because of difficulty swallowing or issues with your stomach or intestines does not qualify you for coverage of a different treatment. If your bone mineral density goes down or you have a broken bone while taking an oral bisphosphonate, you still do not qualify for another treatment.
B.C. is the only province where health professionals must fill out a special authorization form for any osteoporosis treatment. Often, there is a four-month delay in processing forms, a delay that could result in serious problems, like a broken bone.
Broken bones are the main consequence of osteoporosis and they can be devastating. At least one in three women and one in five men will suffer a broken bone from osteoporosis during their lifetime. The population is ageing – by 2036 it is estimated that 25% of the population will be 65 or over. Since age is a risk factor, there will likely be an increase in broken bones as well.
Broken bones can cause acute and chronic pain; they can interfere with your mobility and independence; you fear falling so you limit your activities and become more socially isolated and depressed. Hip fractures can mean going to a long-term care home. Complications arising from a hip fracture can even lead to death. In spite of clear guidelines, screening and treatment rates after a broken bone in Canada are very low. Fewer than 20% of fracture patients are diagnosed, have a bone mineral density test or receive treatment after a fracture.
Dr. David Kendler, professor of medicine (endocrinology) at the University of B.C., is drawing attention to the fact that B.C. Pharmacare, the provincial body that determines eligibility and coverage for medications, is now undergoing a review of its policies regarding osteoporosis treatment, the first since 2008.
The Ministry of Health has created a quick survey for patients, caregivers and patient groups to provide feedback. It asks questions such as how osteoporosis affects your daily life; which bisphosphonates, or other osteoporosis medication, you may have used; your experience with such treatments; whether Pharmacare coverage or limits on coverage affected your choice of medication and if so, how. It opened on October 20 and will remain so only until November 17.
Patients and health providers should take advantage of this opportunity to have their say about osteoporosis care and coverage by Pharmacare.
Access the survey at surveymoh.health.gov.bc.ca/public/survey/therapeutic-review-drugs-used-primary-prevention-osteoporosis.