Rebate needed for ongoing OCT scans: MDFA

On 1 Novber, an OCT it was added to the Medicare Benefits Schedule (MBS). The MDFA welcomed the news that a rebate would be provided for the use of an ophthalmologist-performed OCT scan in the initial diagnosis of wet age-related macular degeneration, diabetic macular oeda and other similar conditions.However, the organisation also expressed concern that only one OCT scan would be reimbursed per year, meaning the rebate would not cover ongoing OCT scans used to monitor the outcome of ongoing eye injection treatments.According to the MDFA, without OCT scans to determine the response to treatment, patients would require monthly eye injections.MDFA CEO Ms Julie Heraghty said, “The addition of [a] new MBS rebate for an initial OCT to facilitate approval of Pharmaceutical Benefits Sche treatment is a good start, but it does not reflect the fact that regular OCT scans are globally accepted as standard of care to guide ongoing intravitreal treatment.

“It is only with the use of OCTs that ophthalmologists can decide when it is appropriate to increase the gap between injections, thereby reducing treatment burden and the overall cost of intravitreal injections, both to the patient and the taxpayer.“Medicare must recognise that OCTs are an essential part of sight-saving intravitreal treatment and provide reasonable reimbursent.”In a statent, the MDFA recommended that up to six OCT scans per year should be funded for the purpose of monitoring response to eye injections, and indicated that it would continue to make representations to Medicare and policy-makers for “a more appropriate” rebate.

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