Vision 2020 Australia welcomes advice that the Pharmaceutical Benefits Advisory Committee (PBAC) has recommended amending existing restrictions for anti-VEGF therapies, to allow ophthalmology registrars and other medical practitioners to prescribe these sight-saving therapies.
In early 2016 Vision 2020 Australia convened a working group of experts to discuss barriers of access to ophthalmology services in rural and remote locations. In particular, the Working Group was concerned about the availability of existing anti-VEGF treatments for diabetes-related eye diseases. In response, Vision 2020 Australia developed a position statement outlining four recommendations to improve access to anti-VEGF therapies.
Three of the four recommendations have now been implemented, including the listing of a Medical Benefits Schedule (MBS) item for Optical Coherence Tomography (OCT) from 1 November 2016. Item 11219 will reimburse the use of OCT as an alternative diagnostic procedure to Fluorescein Angiography (FA) to determine patient eligibility requirements for initial treatment with anti-VEGF therapies.
“Friday’s announcement by the PBAC will further reduce access barriers to equitable eye health and vision care experienced by Aboriginal and Torres Strait Islander people and non-Indigenous people living rurally and remotely,” said Vision 2020 Australia CEO, Carla Northam.
The current authority restriction dictates that the prescriber must be an ophthalmologist, and must be present to receive the call from Medicare with the approval for the treatment.
“This restriction creates inefficiency and is unsustainable in outreach service delivery where the ophthalmologist may only be present in an area for one day, often with 15 or more patients to treat.
“By combining expert advice with effective and collaborative advocacy, Vision 2020 Australia and its members have taken another step forward in ensuring that systemic barriers to accessing eye health and vision care services are reduced wherever possible,” said Ms Northam.
In recommending changes to this treatment criteria, Vision 2020 Australia proposed that, in line with precedent set by other medications, the purely clerical/administrative component of the approval process for anti-VEGF medication be able to be performed by another clinician in consultation with an ophthalmologist. Exactly the same standard of care would apply to the diagnosis, which would be made by the treating specialist ophthalmologist and the treatment itself would also be performed in the same way is it is currently.
About diabetes-related eye diseases
Diabetes Australia estimates that 1.7 million Australians are living with diabetes in 2016 and forecasts show that this figure is expected to grow to 2.45 million by 2030. The National Eye Health Survey told us that more than 453,000 Australians are blind or vision impaired. Studies have also shown that diabetes-related eye diseases, such as Diabetic Macular Oedema (DMO), account for a significant amount of vision loss for Aboriginal and Torres Strait Islander people and working age Australians.
It is also estimated that the total indirect cost of vision loss associated with Diabetic Macular Oedema (DMO) to the Australian economy was $2.07 billion in 2015; and finally, eye health outcomes are poor for those living in rural and remote locations where there is a lack of easily available and coordinated access to specialist services, such as those provided by ophthalmologists.
About Vision 2020 Australia
Vision 2020 Australia is the national peak body for the eye health and vision care sector, representing over 50 member organisations involved in: local and global eye care; health promotion; low vision support; vision rehabilitation; eye research; professional assistance and community support.
Established in October 2000, Vision 2020 Australia is part of VISION 2020: The Right to Sight, a global initiative of the World Health Organization and the International Agency for the Prevention of Blindness.
For more information:
Adam Sawell at Vision 2020 Australia