A proposed Medicare rebate cut to sight saving Anti-VEGF treatment for neovascular age-related macular degeneration (wet AMD) will not be implemented.
The independent Medicare Benefits Schedule (MBS) Review Taskforce for Ophthalmology recommended to the Government that the Medicare rebate for sight saving eye injections be cut by 69%. Economic modelling commissioned by Macular Disease Foundation Australia (MDFA) estimated that the proposed cut would trigger out-of-pocket costs for wet AMD patients to balloon from the current AU$1,900 per year to $3,900 per year – double if the disease impacts both eyes.1
Prior to the Federal election, then Minister for Health, Greg Hunt confirmed his support of the MDFA call to reject the proposed recommendation to cut the Medicare rebate on sight saving treatment if the Coalition was returned to Government.
“Our priority is that Australians get access to this critical treatment to save sight. Optimal health is central to decision making,” Mr Hunt said.
Then Shadow Minister Mark Butler’s office also confirmed that the Taskforce recommendation was not being considered by the Labor Party.
MDFA CEO, Dee Hopkins welcomed the decision saying, “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 its introduction in Australia 15 years ago, sight saving injections have revolutionised the management of multiple neovascular macular conditions including wet AMD, diabetic macular oedema, and retinal vein occlusion. This treatment is non-curative, and it is essential that patients maintain regular injections to retain vision.
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.2
MDFA research found that 29% of patients on this treatment considered delaying or stopping treatment due to cost of treatment, while 40% had considered delaying or stopping treatment due to travel issues accessing their nearest eye doctor.3
“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,” Ms Hopkins said.
1. PwC (2019). Impact of IVI rebate changes.
2. DUSC (2018). Ranibizumab and Aflibercept: Analysis of Use for AMD, DMO, BRVO and CRVO.
3. PwC (2020). Estimating the costs and associated impact of new models of care for intravitreal injections report.