Assessing new models of care for intravitreal injections
Following the Medicare Benefits Schedule (MBS) Review Taskforce for Ophthalmology (the Taskforce) and suggested changes to the Medicare rebates for intravitreal injections, MDFA worked with PwC Australia to undertake economic modelling to determine the impact on patients. The modelling also examined the unintended consequences of offsetting MBS savings to government. It was evident that by cost shifting to other parts of the health system, there would be a direct net cost of $168m over the next four years as people lose their vision and require greater support from the health, aged care and social service systems.
MDFA’s position remains steadfast: we believe that cuts to the MBS for intravitreal injections (IVI) will inherently be passed to patients. In our submission to the Taskforce, MDFA asked for assurance that any cuts to the MBS be quarantined until alternative models can be developed so that Australians can be assured of accessing affordable sight saving treatment, irrespective of where they live.
To provide additional weight to our position, MDFA is once again working with PwC to undertake a cost analysis and assessment of alternate models of care for intravitreal injections. We will work towards a review of these models by October 2020 to highlight the need for systemic change to support vulnerable Australians, who are at risk of going blind without affordable and accessible treatment.
Our approach to this research will be guided by a series of achievable priorities:
● Priority 1 - State/Territory-level modelling of future AMD incidence and corresponding demand for IVI, bearing in mind new therapies in the pipeline that will extend/change treatment timelines.
● Priority 2 - Definition of ‘vulnerable’ AMD patients (Indigenous Australians, pensioners, etc.), plus modelling of current and future AMD incidence and corresponding demand for IVI by State/Territory
● Priority 3 - Identify alternate models of care for intravitreal injection treatment, with specific focuses on public sector care
● Priority 4 - Estimate the cost to government of agreed alternate models of care and the cost of ‘doing nothing’ or not implementing any of the models
● Priority 5 - Consider the impacts associated with these models of care, especially to vulnerable population groups.
Moving forward, MDFA will provide the opportunity for eye health professionals to have input via this newsletter and ongoing surveys. We look forward to updating you on the progress of this important body of work.