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Campaign to pressure Health Minister over glaucoma treatment

Wednesday, June 07, 2017

Image courtesy: Flickr/Community Eye Health 


Following recent changes to Medicare, Glaucoma Australia (GA) is urging people in need of minimally invasive glaucoma surgery (MIGS) to contact the Federal Health Minister.

Prior to May 1, Medicare covered MIGS procedures regardless of whether they were performed in conjunction with cataracts, but now access to the highly effective glaucoma treatment has been restricted.

Recent alterations to Medicare item numbers mean in order to qualify for a rebate, patients now either have to have a cataract operation at the same time or, pay for all costs associated with having a standalone MIGS operation in a private hospital. This includes surgeon’s fee, the theatre and other operating costs, an anaesthetist and the device/s itself, which may not be covered by private insurers.

Even patients who are covered by Medicare may still have to pay more than the cost prior to May 1 as the public healthcare system will not pay any extra to the surgeon for the MIGS part of the procedure.

As a result, GA has produced two templates disadvantaged patients can use to send letters to Minister Greg Hunt to express their dismay at the decision.

“These decisions affect those who have already had their cataracts done; who are older and whom have run out of glaucoma treatment options… Mr Hunt, this is a poor outcome for people requiring a MIGS procedure and I request a return to the situation prior to 1st May 2017, where MIGS operations were eligible for a Medicare rebate. The previous state of affairs should continue until the Medical Services Assessment Committee (MSAC) has reported and a decision has been taken on whether to allow/deny the Medicare reimbursement of MIGS procedures,” part of the first letter states.

Meanwhile, the second letter adopts a more conciliatory approach: “My eye doctor has advised that my sight threatening glaucoma might be better controlled with MIGS surgery, which has evidently been proven to be safe, effective and well accepted here and overseas. I understand the changes introduced by your Department … will require me to fully fund surgical costs of MIGS which is a major financial burden that I can ill afford, especially at this stage of my life.
This decision significantly increases the risk of my vision becoming permanently worse, perhaps even resulting in me going completely blind. This will be bad for me, for my family and will ultimately cost Australian taxpayers more to care for me.”
 
In the past MIGS was usually only used for children with gongenital glaucoma, which limited procedures to around only 20 each year. However, the development of new stents for adults saw the number of procedures skyrocket and led to MIGS’s removal from the MBS, pending a review. 

The results of the review, currently being undertaken by the Department of Health and MSAC, will likely to be released later this year.

IMAGE: Greg Hunt, Federal Minister for Health ...read more

Novartis transfers Australian medications distribution

Wednesday, June 07, 2017

Novartis has confirmed that after June 30 ophthalmic medications, dry eye and allergy eye products will no longer be distributed by subsidiary company, Alcon.

Instead, Novartis, which has been managing distribution in Australia since April 1, indicated products such as Systane and Artificial Tears will be available through third party distributor Clifford Hallam Healthcare (CH2).

Other Alcon Vision Care products, such as contact lenses and the Opti-free range, are not impacted by the change and can still be ordered through the usual channels.

According to a release from franchise director of ophthalmology at Novartis, Mr Marco Muscardo, CH2 was selected as a preferred distributor due to its online ordering tool and willingness to maintain existing pricing agreements.

“CH2 will continue to offer special pricing arrangements that you may have agreed to with Alcon in relation to the Transferring Products. As an introductory offer (and in order to facilitate the ongoing supply of products to you) CH2 is offering a credit of $100 (ex GST) on all new accounts opened prior to 1 July 2017 and redeemable until 30 June 2018 for the purchase of Transferring Products,” he stated.

CH2 is said to have an extensive national distribution network supplying pharmacies and optometrists including throughout regional Australia. 
 ...read more

Indigenous eye health gap reduced but work still needed

Wednesday, June 07, 2017

Image courtesy: Foter/Deetrak 

One-third of Aboriginal or Torres Strait Islander people reported one or more long-term eye conditions last year, according to the Indigenous Eye Health Measures 2016 report.

Commissioned by the Australian Institute of Health and Welfare, the report compiled data from a range of sources and presented findings at the national, state and regional levels. Generally, it found there was still a distinct gap between the eye health of Indigenous Australians compared with the rest of the population, but, there were also indications that improvements were being made.   

One of the key findings that emerged from the investigation was that between 2005-2007 and 2013-2015 the age-standardised Indigenous hospitalisation rate for cataract surgery increased by more than 40% from 4,918 to 7,052 per 1,000,000 – a significant statistic considering cataract was the second leading cause of visual impairment. 

Meanwhile, progress was also made in the fight against trachoma, with the prevalence of the infection in children aged 5–9 in at-risk communities falling from 14% in 2009 to 4.6% in 2015.

Minister for Indigenous Health, Mr Ken Wyatt, said the report – the first of its kind in Australian history – was a valuable source of data that would be used to improve eye health through better detection, management and treatment of eye disease.

“This report is important because from here we can build an evidence base for monitoring changes in Indigenous eye health, and identify service delivery gaps at the regional level,” he said.

“[It] indicates that more Indigenous Australians are accessing eye health services provided through specific service programs. The report finds that in 2014-15 more Indigenous Australians received an eye examination than in the previous twelve months; that the gap in accessing cataract surgery compared to non-Indigenous Australians is narrowing; and the rate of blindness for Indigenous Australians has decreased from 1.9 per cent in 2008 to 0.3 per cent in 2016,”
Wyatt added.

However, he also added: “While the report shows improvements are being made in Closing the Gap in Indigenous eye health, more needs to be done.”

This is evidenced by the fact that Indigenous Australians had a lower age-standardised rate of hospitalisations for eye diseases compared with non-Indigenous Australians, but three times the rate for injuries to the eye. Additionally, in 2014-15 the median waiting time for Indigenous Australians – 142 days – was 58 days longer than for non-Indigenous Australians. 

Vision 2020 CEO Ms Carla Northam said the report was an important step toward closing the gap, particularly with regard to Indigenous eye health.

“Indigenous Australians suffer from vision impairment or blindness at three times the rate of non-indigenous Australians. We hope these new measures will help to improve the effectiveness of national eye
 ...read more

Ophthalmologist receives peak body’s highest honour

Wednesday, June 07, 2017

Ophthalmologist Dr William Glasson has been awarded the Australian Medical Association (AMA)’s highest honour – the AMA Gold Medal.

Glasson received the medal for what has described as his exceptional service to the AMA over many years, along with his ongoing long-term commitment to improving the eye health of Indigenous people. He was also AMA president from 2003–2005, at term that is be best remembered for his role in helping to achieve a solution to the long-running medical indemnity crisis.

Current AMA president Dr Michael Gannon, who nominated Glasson for the medal, said the distinguished ophthalmologist was one of a kind.

“Bill was always a strong and passionate advocate for the AMA, the medical profession, the health system, and patients throughout his time as president, at both state and national level,” Gannon said.  

“Bill’s leadership produced a very positive outcome for the profession and the Australian people, following many years of hard work by his predecessors, the AMA Federal Council, and the State and Territory AMAs. His hours, days, and weeks of tense negotiations with the then Health Minister Tony Abbott paid off. Bill and Tony survived those tough days, and remain close friends to this day.

“Throughout his many crusades and causes, Bill Glasson has at all times worn his AMA hat. He is AMA, through and through. Bill Glasson is a champion, true blue, and one of a kind – a truly deserving recipient of the AMA Gold Medal,” Gannon added.

Aside from his time as president of the AMA, Blasson has also served as president of RANZCO and he was the inaugural head of Cancer Australia. He was also appointed an Officer of the Order of Australia in 2008.

IMAGE: Dr Michael Gannon, AMA president
 ...read more

Open-source retinal camera a ‘disruptor’

Wednesday, June 07, 2017

A New Zealand company that created a set of inexpensive, open-source smartphone devices to take photos of the human retina has once again received critical acclaim.

oDocs Eye Care was named the Most Innovative Mobile Technology Company at the New Zealand Hi-Tech Awards recently, just months after they won over judges Sir Richard Branson and Apple co-founder Steve Wozniak at the Talent Unleashed Awards (TUA) – a global competition that rewards innovation and revolutionary businesses.

At the time, Wozniak said, “this is how disruption is done,” in reference to the company’s retinal imaging adapter, also known as visoScope. When attached to an iPhone, the device converts the phone into a retinal camera, while another oDocs product, the visoClip, is essentially a smartphone slit lamp microscope.

Company representatives have promised to keep the inventions open-source to ensure the products remain affordable and accessible, and will also donate 10% of the profit from every item sold, to charity.

“We have made them extremely affordable and accessible to benefit regions most in need. Conventional equipment would cost around US$20,000–30,000 (AU$27,000–40,000), whereas our devices cost a hundredth of that,” business co-founder Dr Hong Sheng Chiong said.

The open-source devices are also compatible with 3D printing and additive manufacturing. This allows clinicians are to save both time and money as they can simply download the files and 3D print the eye equipment locally.
 ...read more

NIB taken to court over hidden cuts to eye coverage

Wednesday, May 31, 2017


The Australian Competition and Consumer Commission (ACCC) has launched legal action against NIB after it alleged the health insurer had engaged in unconscionable conduct in relation to the removal of certain eye procedures from one of its schemes.

The competition regulator has alleged NIB also contravened Australian Consumer Law by engaging in misleading or deceptive conduct and making false or misleading representations. The allegations centre on NIB’s failure to notify members in advance of its decision to remove the procedures from its “MediGap Scheme”, despite previously making assurances to do so.

It has also been alleged that between June 2011 and October 2016, NIB informed its members that several policies that covered eye procedures would not incur any out-of-pocket expenses, when in fact members could have been liable for such costs. According to the ACCC, NIB made this representation by paying gap amounts on behalf of members for these eye procedures prior to August 2015.

ACCC chairman Mr Rod Sims said consumers had a right to be informed of changes to their insurance cover in advance.

“These changes can result in very large financial consequences at a time when consumers are at their most vulnerable,” he said.

“Private health insurers must ensure their disclosure practices are in line with the Australian Consumer Law. Insurers should not expect consumers to bear the responsibility of making independent enquiries to find out about important changes made unilaterally by insurers.”

Further allegations centre on NIB’s supposed identification of more than 400 members who had received two or more eye procedures in the previous financial year, in circumstances where NIB’s management considered that it “probably ought to proactively communicate” with these members about the MediGap Change. 

Additionally, after a doctor from Newcastle Eye Hospital sent a letter to his patients who were NIB members informing them of the MediGap Change and their right to move to another insurer, NIB contacted the hospital to request a commitment that its medical practitioners not communicate with NIB members or the media about the MediGap Change. 

In response, NIB rejected the allegations made by the ACCC, saying it believes it has acted both lawfully and ethically.
 ...read more

Government funding for ophthalmic research made easier

Wednesday, May 31, 2017

The National Health and Medical Research Council (NHMRC) has overhauled its funding program in a move welcomed by research groups throughout Australia.

The new program is expected to reduce the burden of applying for funding across different schemes by providing consolidated, five-year grants for high-performing researchers at all stages of their careers. It is hoped this will provide more flexibility for collaboration and more time for reseachers to spend on their projects.

Another aim of the revamped program is to provide more opportunities for researchers early in their careers, and also for clinical researchers who split their time between research and caring for their patients.

Federal Health Minister Mr Greg Hunt said, “The new program will support research across the spectrum, from discovery through to translation and commercialisation of new therapies and devices, and the implementation of new policies and practices, tackling the challenges facing our health system.”

RANZCO welcomed the announcement and said it would allow researchers more time in the lab, rather than dealing with administrative tasks.

RANZCO president Associate Professor Mark Daniell said, “Today’s announcement by the NHMRC is a great step forward in advancing medical research in Australia and will make a huge difference to how research into eye disease is carried out. Grant applications take a lot of time to prepare and can often be discouraging, especially for those at the beginning of their research career. Improvements made to the NHMRC grant program will afford researchers at all stages of their career greater flexibility and creativity when it comes to delivering innovative eye research.”. 

“Ophthalmic research is fundamental to understanding eye conditions and developing appropriate treatments for patients, which can lead to better patient outcomes and help to prevent avoidable blindness,” he added. 
 ...read more

Australia to avoid eyecare waiting list crisis

Wednesday, May 31, 2017

Despite a continued rise in demand for ophthalmology services, RANZCO has indicated Australia is unlikely to witness a similar backlog of cases like that recently experienced in New Zealand.

Thousands of patients requiring vital ophthalmic consultations were left stranded late last year, when the Kiwi patient waiting list was at its worst point. In October, one of the country’s 20 District Health Boards had a backlog of more than 7000 patients, and it was also revealed that 30 people were losing their sight while being forced to wait.

However, RANZCO president Associate Professor Mark Daniell said the likelihood of such a scenario playing out in Australia was slim: “An ageing population together with an increase in the prevalence of diabetes means that age-related disease and diabetic complications to the eye are increasing dramatically. It is true that this increase in demand has an impact on delivery of services, particularly in the public hospital system.”

“That said, Australia has a different health system model than New Zealand and so manages this increase in demand differently – in particular, through a private system supported by Medicare that has the capacity to take up the additional burden. For this reason, Australia is less likely to face the same crisis that has occurred in New Zealand.”

“RANZCO communicates regularly with federal and state governments in Australia to raise any eye health policy issues that need to be addressed and to share best practice and innovative approaches. We are also working with the National Medical Training Advisory Network on workforce issues to determine the optimal sustainable solution to the anticipated increase in demand from the ageing population.” Daniell added. 

Activities to clear the backlog have yielded some positive results, but chair of RANZCO’s New Zealand Branch, Dr Brian Kent-Smith, said a long-term approach was needed to avoid similar crises occurring in the future.

“While the historic backlogs are beginning to be cleared, there is a risk of the problem recurring as new patients are being added to waiting lists all the time. A one-off funding injection will help in the short term, but in the longer term a more strategic approach, which takes into account ongoing capacity, needs to be taken,” Kent-Smith said.

Daniell said a similar approach was needed for Australia.

“RANZCO believes that Australia needs a national strategic approach to eyecare to ensure that all patients, regardless of their geographical, cultural or economic situation, have access to the care they need when they need it. We continue to communicate and work with federal and state governments to advocate for policies that will help achieve this,” he explained.
 ...read more

Optical chain fined $69,000 for misleading ad

Wednesday, May 31, 2017

A UK optical chain has been fined £40,000 (AU$69,000) for a ‘misleading’ advertisement concerning its range of blue light protecting lenses.

Boots Opticians published an advertisement in The Times in January 2015, which contained multiple overstating claims about blue light and the benefits of its BPPB lenses according the UK’s optical regulator, the General Optical Council (GOC).

The finding, handed down late last week, came after multiple complaints were lodged with the Advertising Standards Authority (ASA) about the content of the ad. 

Complaints related to claims that blue light from LED TVs, smartphones and energy saving light bulbs caused damage to retinal cells over time, and that BPPB lenses protected against blue light from these sources. The authority found that these claims were misleading and unsubstantiated. 

It was later revealed that despite the ASA’s ruling, some Boots practices were still making the misleading claims about the lenses through in-store leaflets. 

In handing down the fine, which is to be paid within 30 days, the GOC found that Boots’ fitness to practise as a business registrant was impaired and that it had gained a financial advantage through promoting the lenses.

“The committee imposed this level of fine to mark the seriousness of the misconduct and to send a signal to the business registrant, the profession and the public reinforcing the high standards of conduct and behaviour expected of all registrants,” a transcript of the GOC’s decision read.

The GOC took into account the fact that Boots had already incurred financial costs as a consequence of the advertisement and also suffered, and continued to suffer, reputational damage as a result of the transgression before imposing the fine.
 ...read more

Major advances in macular degeneration research

Wednesday, May 31, 2017

(L-R) Damien Harkin, Ita Buttrose, Paul Mitchell, Gerald Liew and Robert Kaye at the Macular Degeneration Awareness Week Research Symposium


Some of Australia’s foremost ophthalmic experts gathered for the annual Macular Degeneration Awareness Week Research Symposium in Sydney last week.

More than 100 people attended the symposium, which focused on macular degeneration research, specifically recent breakthroughs and potential future discoveries. Macular Disease Foundation Australia (MDFA) patron Ms Ita Buttrose discussed her experiences with the condition, before keynote speaker, University of Sydney’s Professor Paul Mitchell, spoke about the major advances in macular degeneration research to date. 

Mitchell, one of the world's leading experts on the epidemiology and treatment of macular diseases, explained the importance of new knowledge concerning risk factors and improved diagnostic tests, before lauding the extraordinary transformation anti-VEGF injections had had on the treatment of wet-AMD. 

He also said the development of an effective treatment for dry AMD was a major global priority and that the increased knowledge regarding the genetics of macular degeneration was creating exciting opportunities for new therapies. 

Following Mitchell, fellow USyd researcher Assistant Professor Gerald Liew detailed the cutting-edge research he was conducting in the new field of metabolomics. His project, which is being partly funded by the MDFA, has the potential to develop a simple new blood test for macular degeneration and may also identify possible new targets for treatment.
 
Then, Professor Damien Harkin from the Queensland University of Technology described his work on a biological scaffold on which new retinal cells can be grown for subsequent transplantation into the eye, which will soon commence clinical trials.

Finally, a wide-ranging panel discussion followed, which included the importance of funding through the NHMRC and the MDFA’s Research Grants Program, the importance of collaboration between researchers, and how future research needs to focus on dry macular degeneration.  ...read more


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