Every hip fracture costs the taxpayer some €9,500, but Malta remains the only EU country where patients have to pay the full price for their osteoporosis treatment.
In 2006, the most recent figures quoted in the latest EU Osteoporosis Report, some 321 people over 65 years sustained a fracture, costing the Maltese health services some €3.07 million.
“The price of treatment has decreased significantly over the past year, and therefore the balance of health economics is leaning more and more towards giving free treatment,” Ray Galea, consultant gynaecologist and president of the Malta osteoporosis society, said.
Literally meaning porous bone, osteoporosis is mainly a disease of the elderly where bones become brittle and susceptible to fracture. As the loss of density and quality of the bone are reduced silently and progressively, fracture occurs mainly in the wrist, hip and spine.
The most commonly prescribed treatment costs range from €15 to €45 a month, but Dr Galea estimates that if the government were to buy the medication in bulk, this figure can be significantly slashed. However, this form of treatment can have considerable gastric side effects, and the alternative costs a good amount more.
Although the common treatment is not particularly expensive, osteoporosis, a condition that affects people over 50 years, is an extra burden on a pensioner’s pocket.
“Nowadays, I tell patients straight up how much treatment costs,” Dr Galea said, adding that many times patients on a pension find it difficult to make ends meet.
It is not just the monetary burden of osteoporosis that has to be born in mind, Dr Galea said, as one in five people will die following such a fracture, and a further two thirds will not return to their former level of independence.
“Many will end up institutionalised or on home help,” he said, pointing out that apart from the social impact, this too increases the cost of untreated osteoporosis on the taxpayer.
It is not only preventative treatment that is not given for free in Malta, but people still have to pay for treatment after the first osteoporotic fracture is sustained.
This in spite of the fact that without intervention, the first fracture is associated with an 86-per-cent increased risk of a subsequent fracture.
Being in southern Europe, Malta has a much lower incidence of osteoporosis than the northern part of the continent, possibly due to genetics and a larger exposure to sunlight.
However, the incidence is increasing with an ageing population.
In Malta, the only form of osteoporosis entitled to free treatment is that which is steroid induced. This small number requires a very specific form of treatment.
The list of conditions entitled to free medicines is being revised, the new list remained mostly shrouded in secrecy and when contacted the Health Ministry was not in a position to say if osteoporosis was going to be included or not.
“I don’t blame government for treading warily because it all boils down to euros,” Dr Galea said.