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Tuesday, 30 October 2012
Page: 8426


To the Honourable President and members of the Senate in Parliament assembled:

This Petition is submitted to the Senate in response to the recent decision by the Health Minister to fund cutaneous Botox treatment for axillary hyperhidrosis.

We would like to bring to your attention that palmar, facial, pedal and severe 'compensatory hyperhidrosis' (which paradoxically is the result of the elective surgical procedure to treat hyperhidrosis) can have an adverse and disabling effect on a person's quality of life, psychosocial well-being and overall health.

Due to its high cost, cutaneous Botox treatment can be prohibitive for these patients. For this reason we would like to petition for funding for cutaneous Botox and lonthoporesis treatments for these conditions. The current, publicly funded treatment of surgical Endoscopic Thoracic 5ympathectomy (ETS) for these conditions is controversial and not supported by high level empirical evidence.

There is concern regarding safety and disclosure of side-effects of ETS procedure, as found in reviews by the Finnish Office for Health Technology Assessment - FinOHTA [1] and the Australian Safety and Efficacy Register of New Interventional Procedures - Surgical 'ASERNIP-S' [2] . We wish to argue that the Medical Benefit Scheme (MBS) listing for ETS should be immediately suspended and availability of this procedure should be urgently reviewed according to the guidelines set out by the Medical Services Advisory Committee (MSAC) stringent (20-step) evaluation process ('Processes relating to the consideration by MSAC of Medical Services - From Initiation to Listing').

The level of endorsement (MBS listing) might impact on how the procedure is perceived by the public who is also exposed to medical advertising on the Internet and in the media. This can result in a skewed understanding of the nature, consequences of the surgical ETS, and the severity of the side-effects.

Clinical decision making can be tainted by bias, especially in the context of entrepreneurial medicine and elective procedures. Information provided to patients, especially in this setting can fall short of accepted standards of 'informed consent'.

The recent MBS listing for cutaneous Botox for axillary hyperhidrosis - a safe and minimally invasive treatment - sets out clear conditions - and restrictions - on its availability. There is no regulation, and no conditions are set for the availability of the irreversible neurosurgical procedure, ETS.

We trust that decisions regarding funding are based on best available evidence regarding safety, effectiveness and cost effectiveness - and in this order. Available high level evidence however cannot, and does not support the use of ETS as a safe procedure.

We request that the Senate call on the Minister for Health to:

- Remove funding for Endoscopic Thoracic Sympathectomy for Hyperhidrosis and blushing and review the availability of this procedure.

- Extend funding for safer, less invasive alternative treatments (cutaneous Botox and lonthoporesis) for people with palmar, facial, pedal and severe 'compensatory hyperhidrosis.

We look forward to your assistance in ensuring all Australians have a right to a fair medical system, where all surgical procedures are science based, have an objective trial and high level evidence regarding safety; and alternative treatments are offered at a reasonable cost.

Yours faithfully,

The Signatories,

By Senator Kim Carr (from 10 citizens).

Petition received.