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Dexamethasone for Uveitis on PBS

Dexamethasone for Uveitis on PBS

The Royal Australian and New Zealand College of Ophthalmologists is pleased with the announced introduction of dexamethasone (Ozurdex®) as a Pharmaceutical Benefits Scheme (PBS) authority prescription for non-infectious uveitis affecting the posterior segment.

The inclusion of the medication on the PBS means that approved patients will not have to pay the full price for the medication. Before 1 April 2018, patients living with uveitis who are prescribed dexamethasone may have needed to pay over $2,700 per course for the treatment and management of the condition. From 1 April 2018, approved patients are able to purchase the medication with access to the PBS maximum patient co-payment rate of $39.50 per course of treatment, or at $6.40 concession.

RANZCO advocated for the inclusion of dexamethasone onto the PBS, in order to allow uveitis patients access to a potentially vision-saving medication. In the decision of the Pharmaceutical Benefits Advisory Committee, RANZCO’s comments to the PBAC were noted as part of the positive consideration. Earlier this week, Health Minister Greg Hunt confirmed the inclusion of dexamethasone for non-infections uveitis on the PBS, as per the PBAC recommendation.

RANZCO is delighted by this outcome and will continue to work with the Department of Health to drive improvements in eye health care in Australia, New Zealand and the Asia-Pacific region.

New Medicare item number (42705) listed for MIGS

New Medicare item number (42705) listed for MIGS

Following continued discussions between RANZCO and the federal Department of Health, a new Medicare item number (42705) has been listed today for the implant of minimally invasive glaucoma surgery (MIGS) devices. The new item number is an interim measure only, with a current expiry date of 31 December 2017.

It follows the notification that as of 1 May the goniotomy item number 42758 cannot be used for the implant of MIGS devices. The new item number is specifically designed to allow the continued implant of devices whilst a full MSAC review is underway. It can only be done in conjunction with cataract surgery and does not provide a specific rebate for the surgical component other than the cataract element.

However, following the discussions with the Department of Health it should not be assumed that the restrictions applied now, including the implant in conjunction with cataract surgery, will be the same if the MSAC review is positive. RANZCO will continue to work with MSAC and the Department of Health as they undertake a full review with a result expected later this year.

The exact item number is:

Upcoming changes to Ophthalmology MBS items 1/5

From 1 May 2017, a number of changes to Ophthalmology procedural Medicare Benefits Schedule (MBS) items will take effect. These have been a product of ongoing discussions between the College and the Department of Health.

Please note that these changes are not part of the formal MBS Review process. The MBS Review Ophthalmology Committee is expected to be announced later this year. The College will continue to update Fellows on the MBS Review and other changes to Ophthalmology MBS items.

One significant change that Fellows should note is the limitation placed on MBS item 42758 (goniotomy). In practice, this change means that glaucoma stents cannot be billed for MBS rebate using this item. This change came about despite repeated advocacy efforts by the RANZCO Medicare Advisory Committee and the Australia and New Zealand Glaucoma Society to explain the impact of this change to the Department of Health. RANZCO will continue to advocate for the proper inclusion of stents into the MBS schedule.

The full list upcoming changes, effective 1 May, are detailed below. Changes to existing item wording are presented in underline.

  • MBS item 42725: VITRECTOMY via pars plana sclerotomies including the removal of vitreous, division of bands or removal of epiretinal membranes, and including capsulotomy if performed.
  • MBS item 42734: CAPSULOTOMY, other than by laser, not being an item associated with items 42725 or 42731.
  • MBS item 42758: GONIOTOMY for the treatment of primary congenital glaucoma, excluding the minimally invasive implantation of glaucoma drainage devices (H).
  • MBS item 42788: LASER CAPSULOTOMY – each treatment episode to 1 eye, to a maximum of 2 treatments to that eye in a 3 year period, not being an item associated with item 42702.
  • MBS item 42789: LASER CAPSULOTOMY – each treatment episode to one eye – if it can be demonstrated that a third or subsequent treatment to that eye (including any treatments to which item 42788 applies) is indicated in a 2 year period, not being an item associated with item 42702.
  • MBS item 42791: LASER VITREOLYSIS OR CONTRICOLYSIS OF LENS MATERIAL OR FIBRINOLYSIS, excluding vitreolysis in the posterior vitreous cavity – each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period.
  • MBS item 42792: LASER VITREOLYSIS OR CORTICOLYSIS OF LENS MATERIAL OR FIBRINOLYSIS, excluding vitreolysis in the posterior vitreous cavity – each treatment to one eye – if it can be demonstrated that a third or subsequent treatment to that eye (including any treatments to which item 42791 applies) is indicated in a 2 year period.
RANZCO’s Choosing Wisely messages launched

RANZCO’s Choosing Wisely messages launched

Today RANZCO participated in the Choosing Wisely Australia launch, together with 13 other Colleges and professional associations.
The launch took place at the offices of NPS Medicinewise in Sydney, and included representatives of Colleges and professional associations, together with consumer groups, government representatives, journalists, and other stakeholders.

Altogether, 61 new Choosing Wisely messages were launched today, five of which by RANZCO:

In the absence of relevant history, symptoms and signs, ‘routine’ automated visual fields and optical coherence tomography are not indicated.

AREDS-based vitamin supplements only have a proven benefit for patients with certain subtypes of age-related macular degeneration. There is no evidence to prescribe these supplements for other retinal conditions, or for patients with no retinal disease.

Don’t prescribe tamsulosin or other alpha-1 adrenergic blockers without first asking the patient about a history of cataract or impending cataract surgery.

Intravitreal injections may be safely performed on an outpatient basis. Don’t perform routine intravitreal injections in a hospital or day surgery setting unless there is a valid clinical indication.

In general there is no indication to perform prophylactic retinal laser or cryotherapy to asymptomatic conditions such as lattice degeneration (with or without atrophic holes), for which there is no proven benefit.
The launch was attended by Dr Clayton Barnes, Chair of RANZCO’s Choosing Wisely Committee, and A/Prof Alex P Hunyor, Chair of RANZCO’s Medicare Advisory Committee.

After the launch, Dr Barnes addressed RANZCO’s staff members at the RANZCO office in Sydney, explaining the campaign messages and their development process.

For more information, please see:

Media release: RANZCO launches its Choosing Wisely Australia messages

RANZCO’s Choosing Wisely messages: public information sheet

Do I really need a supplement for my macula?

Rare eye disease treatment gets boost from bionic eye

Rare eye disease treatment gets boost from bionic eye

speedBlind people suffering from rare eye disease have been given new hope with the successful trial of a bionic eye which partially restores vision.

A recent 60 Minutes story, in addition to several clinical trials around the world, have profiled the bionic eye in relation to sufferers of rare eye diseases such as retinitis pigmentosa, which is inherited and incurable.

Retinitis pigmentosa causes the gradual degeneration of light receptors in the retina, severely impairing vision and leading to blindness in many cases. The bionic eye is a retinal implant that stimulates electrical impulses within, sending this information to the brain to “trick” it into allowing vision, albeit not normal vision but enough for the patient to make out shapes and perceive shades of light. This allows the patient to resume some of the basic tasks of living not possible before the implant.

The bionic eye is currently not available in Australia, although development is well under way. It is thought such devices will also help in the treatment of macular degeneration, the leading cause of blindness globally.

The bionic eye, called Argus II, consists of two separate components: a camera and visual processing unit the patient wears, and the surgically-implanted antenna and electrodes. Results are not instantaneous, as it takes time for a patient not used to seeing for a long time to re-learn how to interpret visual information, and to adapt to the data provided by the electrode signals.

Such advances are bringing technology and ophthalmology closer together, while also expanding the field of neuro-ophthalmology into exciting new areas.

Ophthalmology research part of the $120 million for tomorrow’s medical breakthrough

Ophthalmology research part of the $120 million for tomorrow’s medical breakthrough

Australian

RANZCO commends yesterday’s government announcement of $123.5 million in grants to ensure Australia remains at the forefront of medical health and research and a world leader in preventing, treating and curing illness and disease.

Ophthalmology research featured in the group of over 100 top Australian researchers and projects to share in the National Health and Medical Research Council grants.

These include:

Dr Hong Zhang, Development Grant, Centre for Eye Research Australia ($584,165)

This research supports the development of a non-invasive treatment for the degenerative eye condition keratoconus. Current treatment involves lifting the protective layer of the cornea to apply riboflavin to the central region of the cornea – a procedure which can be painful and carries many risks of complications. Professor Zhang will work with Seagull Technologies to develop a polymer gel that, combined with a delivery device invented by the company, can release riboflavin into the cornea safely and without the need for any incision

Prof Yogesan Kanagasingam, Development Grant, Australian e-Health Research Centre (516,424)

Low cost smart screening system for sight threatening eye disease: diabetic retinopathy

Dr Queena Qin, Postgraduate Scholarship, Centre for Eye Research Australia

Energy supply in glaucoma: one cell’s trash is another cell’s treasure

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