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Thursday, 1 November 2012
Page: 8905

Medical Services Advisory Committee

(Question Nos 2167 and 2168)


Senator Abetz asked the Minister representing the Minister for Health, upon notice, on 17 September 2012:

With reference to the Medical Services Advisory Committee (MSAC):

(1) Did MSAC request that a national data collection of clinical outcomes for non-diabetic problem wounds and ulcers be implemented.

(2) Were the findings of the national study accepted by MSAC in the 2012 assessment Review of Interim Funded Service: Hyperbaric Oxygen Treatment (HBOT), report no. 1054.1; if not, why not.

(3) Was the data accepted as the best available data and embodied in the report.

(4) Did the MSAC report analyse the cost of HBOT as a primary treatment for problem wounds and ulcers, despite listing it as a secondary intervention in its clinical pathway.

(5) Is it correct that HBOT is overwhelmingly regarded as a second-line treatment for problem wounds and ulcers, to be used only after a standard treatment has failed over a period greater than 3 months; if so, why was HBOT analysed as a primary treatment.

(6) Did the report, dealing with 154 patients across Australia, suggest that there was an additional treatment cost of $331 256 if HBOT was used as a first-line treatment, a cost of $2 151 per patient.

(7) Did the MSAC 1054.1 committee state that the healing rates of HBOT and normal wound care are identical, without supporting evidence, and if the outcome is predetermined as being equal, can any form of additional treatment ever be cost effective.

(8) Is it accepted that HBOT has no genuine comparator as it is a second-line treatment.

(9) Can the Minister confirm that the patients included in the national wound care database presented only after having a wound for an average of 19 months, nearly 70 per cent of which healed after 6 months.

(10) Is the Minister aware of any other treatment with a comparable level of success in treating long-term indolent wounds.

(11) Will there be a shift in costs from the Federal Government to state governments as a result of withdrawing the Medicare number for HBOT.

(12) If the Medicare number is withdrawn, will hospital patients undergoing HBOT cease to receive cover from their private health insurance fund, thereby causing a further shift in costs to the states.

(13) Has any analysis been undertaken as to the consequences of this determination by MSAC on the hyperbaric facilities and their ongoing viability at the Royal Hobart Hospital, the Wesley Centre and other treatment centres in Australia, including those in Berwick, Brunswick, Sydney and Perth.

(14) Does MSAC have an independent appeals process when it recommends the withdrawal of public funding for existing treatments.


Senator Ludwig: The Minister for Health has provided the following answer to the honourable senator's question:

(1) to (9)

Refer to the Assessment Report and Public Summary Document of the November 2011 MSAC meeting, available on the MSAC website at:

http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1054.1

(10) All other treatments were considered by MSAC. Refer to the Assessment Report and Public Summary Document of the November 2011 MSAC meeting.

(11) Services provided by state and territory governments is a matter for them.

(12) Private health insurance fund providers make their own business decisions.

(13) MSAC's role is to advise on the level and quality of evidence relating to the safety, clinical effectiveness and cost-effectiveness of medical services.

(14) In relation to MSAC application1054.1, following a request from the applicant the MSAC reconsidered the application at its meeting of 2 August 2012 and confirmed its previous advice to government, again unanimously. In response to a further request from the applicant, the Department arranged for independent review by the National Health and Medical Research Council (NHMRC). On 11 October 2012, NHMRC advised the Department that the MSAC process and assessment was sound. The applicants are able to make a new application to the MSAC at any time.