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The Medical Services Advisory Committee (MSAC) is currently reviewing a submission for public funding for Micro-bypass Glaucoma Surgery (MBGS) device implantation as a standalone procedure for patients with open-angle glaucoma. The procedure in question is more commonly known as minimally invasive glaucoma surgery (MIGS).
As the peak advocacy body representing people with glaucoma, Glaucoma Australia strongly supports recent submissions by The Royal Australian and New Zealand College of Ophthalmologists (RANZCO), The Australian and New Zealand Glaucoma Society and peak industry bodies. The application is currently under review by MSAC with a result expected in the coming months.
In May 2018, Glaucoma Australia CEO Annie Gibbins penned a letter to MSAC Chair Professor Robyn Ward strongly supporting the application to list MIGS as a standalone procedure in patients with open-angle glaucoma.
Currently minimally invasive glaucoma surgery (MIGS) procedures can only be conducted in conjunction with cataract surgery under a combined Medicare item number, making this sight saving procedure cost prohibitive for many Australians with primary open-angle glaucoma.
“The majority of patients for whom the stents are indicated are unlikely to require cataract surgery – hence in affect this restriction will only allow a minority of suitable Australian patients to access the micro-bypass glaucoma stents” writes Mrs Gibbins.
“Not to support this application is condemning some people to avoidable disability and potentially blindness” she added.
“Our initial experience with MIGS, supported by the growing body of international scientific literature, clearly defines a crucial role for MIGS in glaucoma surgical management. Allowing Australians access to MIGS will ensure their glaucoma is optimally treated.” - Dr Simon Skalicky, Chair of the Ophthalmology Committee, Glaucoma Australia.
Background
Prior to 1 May 2017 minimally invasive glaucoma surgery (MIGS) procedures were performed under the Medicare item number for goniotomy (42758) which meant the cost of the device (“stent”) was likely to be fully/mostly paid for by your private health insurer.
From 1 May 2017, the Department of Health notified that the goniotomy item number could no longer be used for the implant of MIGS devices for treating glaucoma pending a full MSAC review.
Following continued discussions between RANZCO and the federal Department of Health, a new Medicare item number (42705) was listed for the implant of MIGS devices. However the procedure can only be done in conjunction with cataract surgery and the item number does not provide a specific rebate for the surgical component other than the cataract element.
The new item number which is currently being used was specifically designed to allow the continued implant of devices whilst a full review by the Medical Services Advisory Committee (MSAC) takes place.
An initial application to list MIGS as a standalone procedure in patients with open-angle glaucoma was not supported by MSAC in November 2017 due to insufficient evidence of effectiveness. Since this decision industry experts from ophthalmology and device companies have continued to work with MSAC and the Department of Health with the full support of Glaucoma Australia.
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