Macular Disease Foundation Australia (MDFA) has had an undertaking by both major political parties that they won’t implement an MBS Review Taskforce proposal to cut the intravitreal injection rebate by 69%, in a major win for the eye health sector.
The organisation announced on Monday 2 May that Federal Health Minister Mr Greg Hunt – who is exiting politics after the 21 May election – is supporting the MDFA’s call to reject the proposed rebate cut, if the Coalition is returned to government.
Shadow Minister Mark Butler’s office has also confirmed to MDFA that the Labor party would not be considering the recommendation if elected.
It will be welcome news for MDFA, macular disease patients and ophthalmologists who have campaigned for a long time on this issue, and were not expecting a decision this side of the election. It also coincides with MDFA’s Macula Month awareness campaign held annually in May.
RANZCO released a statement, applauding MDFA for its efforts in securing commitments from the government and opposition that the proposed rebate cut would not materialise.
The ophthalmic sector has been alarmed ever since the independent Medicare Benefits Schedule (MBS) Review Taskforce for Ophthalmology recommended the government slash the MBS fee from $310 with a rebate of around $250, to a $96 fee with a rebate of around $75.
Economic modelling commissioned by MDFA estimated the proposed cut would trigger out-of-pocket costs for neovascular age-related macular degeneration (nAMD) patients to balloon from the current $1,900 per year to $3,900 per year – double if the disease impacts both eyes.
Ophthalmologists were concerned about prohibitive costs affecting treatment adherence, while pushing patients into an already-overwhelmed public system.
Clinics providing bulk-billed eye injections said the proposed fee would have made it difficult to continue providing the service and would have likely needed to start charging out-of-pocket fees. However, it is not yet clear whether this undertaking from both the Liberal and Labor parties will impact the fee ophthalmologists get for intravitreal injections.
MDFA said Hunt had confirmed the specific recommendation regarding the patient rebate for intravitreal injections was not under consideration. He invited the foundation to be part of the Implementation Liaison Group established to review the recommendations and to ensure it would not lead to unintended consequences for patients or barriers to access treatments.
“Our priority is that Australians get access to this critical treatment to save sight. Optimal health is central to decision making,” Hunt said.
MDFA CEO Ms Dee Hopkins added: “MDFA welcomes this decision by the two major parties. Out-of-pocket costs are a driver of patient adherence to treatment. Our modelling showed that the proposed cut would have resulted in an additional 47,000 Australians experiencing permanent vision loss or blindness in the next five years.”
Since their introduction in Australia 15 years ago, Hopkins said anti-VEGF injections have revolutionised the management of multiple neovascular macular conditions, including nAMD, diabetic macular oedema, and retinal vein occlusion.
While MDFA supported many of the 19 recommendations made by the MBS Review Taskforce, it had concerns about the impact of the proposed rebate cut to patients in a system that is already challenging for many to access.
Government data shows that 25% of patients receiving eye injections drop out of treatment after the first 12 months, leading to irreversible vision loss or blindness.
MDFA research found 29% of patients on this treatment considered delaying or stopping due to costs while 40% had considered delaying or stopping due to travel issues accessing their nearest eye doctor.
“We look forward to working with the government of the 47th Parliament to ensure all Australians have improved access to sight saving treatment – particularly as our population ages,” Hopkins said.
Aussies’ eyes are closed to sight-saving treatment
To mark Macula Month, MDFA has released the results of a new YouGov poll conducted online between 9-13 Feb 2022. It comprised a nationally representative sample of 1,042 Australians aged between 50 and 70. After interviewing, the data were weighted by age, gender and region to reflect the latest ABS population estimates.
While anti-VEGF injections have saved the sight of thousands of Australians since 2007 – the MDFA-commissioned study revealed most Australians are unaware of this sight-saving treatment.
It found fewer than one in 10 people aged 50-70 know eye injections are a treatment option that can halt vision loss and blindness caused by this disease.
Only 18% of respondents understood treatment options are available for wet AMD, and of those, less than half (48%) knew about eye injections.
Hopkins said before ground-breaking anti-VEGF treatments were introduced to Australia 15 years ago, most people with nAMD experienced severe vision loss or blindness within two years of being diagnosed. Today, with regular treatment, she said patients can maintain their vision and enjoy active lives long after diagnosis.
“Eye injections have changed the outlook for Australia’s macular disease community – but this lack of awareness is alarming,” Hopkins said.
“Regular eye exams can pick up the early signs of AMD and allow you to begin treatment as soon as you need it. Understanding that therapies are available is critical because early diagnosis and starting treatment immediately gives you the best chance of saving your sight.”
According to MDFA, Aussies continue to rank their vision as their most precious sense. Going blind (45%) rated higher than losing memory (40%), a limb or mobility (17%), hearing (6%) and speech (2%) on respondents’ list of health concerns.
Overall, 86% of over-50s have heard of AMD – a figure that continues to trend upwards, MDFA said.
In contrast, while one in six Australians aged 50-70 confirmed they live with diabetes, only 26% of that age group have heard of diabetic retinopathy and fewer still (22%) have heard of diabetic macular oedema.
Despite these diabetic eye diseases being the leading cause of blindness in working-aged Aussies, only 17% of respondents were aware that they can also be treated by injections.
More reading
Annual out-of-pocket eye injection costs to double to $3,900 under rebate cut – modelling
MBS Taskforce keeps controversial eye injection proposals in final report
MBS eye injections plan could spell disaster for public system, ophthalmologist warns
