New rules curtailing access to Medicare-subsidised bone density tests are reasonable and evidence-based, a leading endocrinologist says.

Patients aged 70 or above with minimal bone loss (osteopenia) or normal bone density will only have access to one MBS-rebated bone density test every five years, instead of every two.

Those at greater risk of fracture can still access the test every two years.

Professor Peter Ebeling, an endocrinologist and chair of the division of medicine at Monash Health, said the change made sense given the under-utilisation of the Medicare item since its introduction, particularly in men.

“The reason is based on new evidence that came out a couple of years ago showing the optimal frequency for bone density testing depends on how low it is initially.”

Under the changes which came into effect this week, Medicare will no longer subsidise Quantitative Computed Tomography (QCT), after a Medicare Review taskforce deemed it was a ‘low value’ practice compared to Dual Energy X-ray Absorptiometry (DEXA).

Professor Ebeling said QCT had been useful in the past when DEXA machines were scarce, particularly in regional Australia.

“These days there are more DEXA machines available. It can be still a problem for remote Australia and in some indigenous communities, but in some places mobile DEXA units go to rural areas so I think the change will have a minimal impact on patient care.”

“The changes seem reasonable to me. I am very glad the screening for 70-year-old Australians hasn’t been abolished, but it needs to be utilised more to diagnose osteoporosis.”