Park, a 59-year-old osteoporosis patient, received alarming news during a hospital visit last April: “You exceed the bone density criteria, so your health insurance may not cover the medication moving forward.” Faced with the financial burden of medication costs and contemplating stopping treatment, Park was relieved to receive encouraging news in May and returned to the hospital.
South Korea’s Ministry of Health and Welfare has recently expanded health insurance coverage for osteoporosis treatments, which is a positive development for patients. The medical community praises this initiative as a proactive step to ensure citizens enjoy healthier, fracture-free aging.
Before this expansion, insurance coverage criteria stipulated that patients diagnosed with osteoporosis needed to have a bone density T-score of -2.5 or lower. If their T-score improved above -2.5 through treatment, their insurance coverage would be terminated, complicating the ongoing disease management.
As of May, coverage has been expanded to include patients whose T-scores, after treatment, fall between -2.5 and -2.0. This adjustment allows for coverage for up to two years, ensuring continued support for those managing their condition.
Osteoporosis is a chronic condition that causes bones to weaken with age, significantly increasing the risk of fractures from minor impacts. Currently, there is no cure. When fractures occur, essential activities like standing and walking can become increasingly difficult, significantly affecting daily life.
Osteoporosis often presents no symptoms until a fracture occurs, making regular bone density testing essential for early detection. Weakened bones can fracture from light impacts, such as bumping into furniture, emphasizing the need for caution.
Fractures in critical areas, such as the spine, pelvis, and thigh bones, can lead to prolonged bed rest and a higher risk of complications like pressure sores, thrombosis, and pneumonia. Severe cases can result in physical disabilities or even death, imposing significant emotional and financial burdens on families.
Once osteoporosis fractures occur, the risk of subsequent fractures can increase by as much as tenfold, with the prognosis worsening with each new fracture. Studies indicate that 20% of patients with thigh bone fractures die within a year, underscoring the importance of preventing the first fracture.
If diagnosed with osteoporosis, it’s crucial to begin treatment promptly and maintain a consistent regimen. Just as patients with hypertension or diabetes continue their medication even after stabilizing their condition, individuals with osteoporosis should pursue lifelong treatment to manage their bone health.
The American Association of Clinical Endocrinology (AACE) advises that once patients are diagnosed with osteoporosis, they are still clinically classified as such, even if their T-score improves after treatment. Long-term, consistent treatment is recommended to minimize fracture risk.
Yoon Seung Hwan, President of the Korean Spinal Neurosurgery Society and a neurosurgery professor at Inha University Hospital, stated, “We can now set appropriate treatment goals based on individual conditions and choose effective medications to manage bone density.”
Yoon highlighted that treatments like denosumab allow patients to increase their bone density and reduce fracture risk with just a biannual injection rather than requiring daily medication. He emphasized the importance of seeking appropriate treatment before any fractures occur.
However, statistics indicate that only one in three osteoporosis patients in South Korea receives medication for their condition. Additionally, more than half of those who begin treatment discontinue it within six months, leading to low adherence rates.
Yoon added, “In the past, insurance coverage would end once bone density improved, making consistent treatment difficult. Even if the T-score exceeds -2.5, coverage can be extended for up to two years as long as it remains below -2.0.”
Following this recent expansion of medication coverage, plans are underway to broaden national health screenings for osteoporosis to include all women in their 60s, in addition to current screenings for those aged 54 and 66. This is particularly vital as women face an increased risk for rapid bone density loss after menopause due to decreased estrogen levels.
Yoon concluded, “With a supportive environment now for osteoporosis patients. It’s essential to recognize the need for lifelong bone density management, similar to other chronic conditions, to ensure safe and healthy aging without fractures.”