August 11, 2009
Chevy Chase, Md. -- Hypogonadism, also known as testosterone deficiency, affects 4-5 million men in the United States placing them at risk for developing osteoporosis. Despite the clear association of testosterone deficiency with low bone density and osteoporosis, Medicare does not provide coverage for bone density testing for these individuals. To address this concern, today The Endocrine Society issued a Position Statement, endorsed by the National Osteoporosis Foundation, calling for Medicare coverage of bone density testing to be extended to this at-risk population.
Bone mineral density, measured by dual energy x-ray absorptiometry (DXA), is an excellent predictor of the risk of fractures in both men and women. Nationally, Medicare currently provides coverage for DXA scans in men only when an individual has been previously diagnosed with osteoporosis, osteopenia or has had a vertebral bone fracture. This means that most men found to have osteoporosis are diagnosed only after a hip or spine fracture has already occurred.
"The lack of Medicare coverage for DXA scans in men with hypogonadism results in underdiagnosis and undertreatment of osteoporosis, resulting in significant morbidity, mortality,and cost to society," said Robert Vigersky, MD, president of The Endocrine Society. "The Endocrine Society recommends widening the scope of Medicare coverage to include bone density scans for men with testosterone deficiency."
In the United States, 2 million osteoporotic fractures occur each year; 29 percent of these occur in men. Men also account for more than 80,000 hip fractures in the United States each year. In 2005, osteoporosis-related fractures in men were responsible for an estimated $4.3 billion in health care costs. By 2025, experts predict that these costs will rise to approximately $6.3 billion.
There are a variety of conditions which cause hypogonadism, including tumors of the hypothalamus or pituitary gland, inflammatory or infectious diseases which affect the testes and even normal aging. Medications can also cause testosterone deficiency.
"The benefits of extending Medicare coverage of bone density testing in hypogonadal men should be more than enough incentive to change policy," said Vigersky. "Extended coverage can help prevent painful osteoporatic fractures and help reduce the high costs associated with those fractures."