Dear Colleagues

Together with the Board and our Secretariat, it has been an action filled few months since I took over the Presidency in May.

The list of topics is long – please try and take the time to get through them all:

• Inaugural AANMS Theranostics Course
• Indexation Campaign
• Lutetium PSMA
• Governmental Relations – Department of Health; Department of Industry, Science and Resources
• ARTnet EOI – Executive Committee
• Colleges: RACP and RANZCR
• Stakeholder Engagement with ANSTO
• Media and Website

A/Prof Sze Ting Lee MBBS PhD FRACP FAANMS FANMB
AANMS President

Inaugural AANMS Theranostics Course

Congratulations to all involved in our inaugural Theranostics Course, held in Brisbane last month, especially David Pattison for convening the Course. We couldn’t have asked for more engaging speakers and audience on the relevant topics, and the feedback to date has been overwhelmingly positive. I was pleased to see that one third of the membership attended, together with technologists, scientists, nurses and patient advocate groups.

We will be receiving the survey results from the attendees who responded and this will definitely inform us to add value to the next course, currently scheduled for 2024.

Attendees also note the course material is available should you wish to recap on any of the topics, as are the certificates of attendance. You can download your certificate via their registration dashboard using the following link: https://members.asnevents.com.au/register/event/1810

Please also note the AANMS Theransotics Position Statement has been recently updated and is available on our website here.

I would like to thank our sponsors and exhibitors who contributed to the event so generously, and ASN Events who made the event possible.

Indexation Campaign

We continue our indexation campaign with the new government and have submitted an updated Pre-Budget Submission.

Lisa Maddocks and I recently had productive meetings with Mark Butler’s office– Federal Minister for Health; Anne Ruston – Federal Shadow Minister for Health; Monique Ryan – new Independent Federal Member for Kooyong and Member of the standing parliamentary committee on Health, Aged Care and Sport; and Rob Mitchell office– Labor Member for McEwen and Chair of the standing parliamentary committee on Industry, Science and Resources.

In August, I met Travis Haslem, who is the First Assistant to the Secretary of the Department of Health (Prof Brendan Murphy), to further discuss our Indexation Campaign, who provided further insight into the decision-making process for this to occur, which we will be targeting in our lobbying campaign, with the assistance of our campaign partners, CMAX Advisory.

In addition, I attended the AMA conference in July and managed to pose a question to Mark Butler directly re lack of indexation in nuclear medicine. I have also garnered support from the AMA on our indexation campaign and our General Manager and I are meeting with the new President again as soon as practicable.

We cannot stress enough the importance of getting the Indexation message out there and we are happy to help you approach your newly elected local Federal Member. Do remember we have resources on the Member Portal on political engagement that you have access to here.

You can also contact our General Manager Lisa Maddocks for assistance – gm@aanms.org.au

Lutetium PSMA MSAC application

The Lu-PSMA MSAC application was assessed by MSAC on 29 July 2022 and we have had very positive feedback on the submission.

We were pleased with the MSAC decision that LuPSMA I&T therapy represented a safe, clinically efficacious treatment for metastatic castrate resistant prostate cancer, equivalent to LuPSMA-617, and most importantly addressed an unmet need for these patients, as it was well tolerated and effective in controlling symptoms. However, despite this, it was not approved for funding as it was not considered to be good “value for money” when compared with an off-patent chemotherapy drug, cabazitaxel. Unfortunately, this results in continued inequitable access for the patients who require it as their best management.

So, where to from here? We have great allegiances with patient advocacy groups, especially Movember, and together with them and PCFA, we will be directly interacting with the Minister for Health and the Department of Health for further action on getting LuPSMA funded for our patients who need it.

I would very much like to thank our dedicated expert members and colleagues from Medical Oncology involved in this application, who have provided their expert advice on the evidence for the submission impartially for the sole purpose of making a funded LuPSMA available for Australians who need this treatment for quality of life and survival.

The impetus for this MSAC submission was based on the successful ARTnet supported TheraP study, which was a multi-centre Australian study on LuPSMA vs cabazitaxel, published in The Lancet Oncology in 2021. The fact that the TheraP study is the gift that keeps on giving as a testament to the robust data gathered. Most recently, the latest paper on Imaging Biomarkers from this study was presented at EANM, as a Top Trials presentation, and co-published in The Lancet Oncology. This research analysing centrally collected PET images highlighted the strong predictive role of PSMA PET/CT and prognostic role of FDG PET/CT when selecting patients for Lutetium-PSMA therapy. Special congratulations to Prof Michael Hofman, Dr James Buteau, Prof Louise Emmett and the entire TheraP team at 11-sites around Australia. Dr Buteau presented the research and received the EANM Young Author Award for best oral presentation.

Manuscript available here.

Medscape coverage here.

Government Relations

Department of Health (DOH)

Our monthly meetings continue with the Diagnostic Imaging Division, DoH. This has resulted in consultations regarding PET substitution for Tl-201 for myocardial viability and Ga-67 for infection imaging. Although these products are slowly becoming available in Australia, we are well aware that this is for a much greater price point than previous supply, and we are in continued discussions with the Department about an increase in rebate to reflect this phenomenal increase in radiopharmaceutical cost, to try to ensure that access to these radiopharmaceuticals is still possible. Similar discussions are also being held for radiotherapeutic agents like I-131 and Y-90, and we hope to hear some positive news on this in the near future.

• PET Supervision. They thanked us for our response and advised they are putting together a paper for the DIAC meeting in November and will be advising government after that date
• Dotatate PET indications – we discussed updating the description to become more generic (rather than restricted to GEPNets) of which the Department advised for us to initially send an email to them outlining the issues and they will advise the best process to pursue
• Radionuclide therapy rebates – DoH advised that these are currently under consideration and will being going to government for approval. This decision is not linked to the current NM review but linked to the MBS Taskforce review of 2018 so should be advised before the results of the current NM review
• Funding of radiopharmaceuticals– DoH is considering a third alternative mechanism (outside of MBS and PBS) but the concept is in its infancy. They would like to work further on this with us and we would keep this on the agenda

National Health Reform Act (NHRA) is being rolled out nationally, which is affecting the entire country, but particularly our members in NSW, SA and Queensland. The Department advised the changes are to ensure only one payment is made for each service; public patients paid via NHRA and only ‘true’ private service should be billed to Medicare. They were made aware of online examples which state that all services from an initial public encounter are to be considered public indefinitely, and this is being reviewed. Geoff Schembri has also made an initial approach to ASMOF NSW regarding their efforts in this area so far. An approach to this would likely require involvement of multiple unions, specialist societies/representative bodies, including the AMA.

Please ensure you contact our General Manager if there are items you would like us to consider for our monthly DoH meetings.

Department of Industry, Science, Resources (DISR) 

We met with DISR in July to discuss to discuss the Government’s strategy for developing local nuclear medicine industrial capabilities and supply chains as well as to gain insight into DISR’s nuclear medicine review.

As it was early days for the new government it became mainly introductory discussing high level topics such as the National Reconstruction Fund.

The DISR is currently conducting an Australia-wide consultation process, which our General Manager attended, and we have submitted our feedback on supporting the call for Nuclear Medicine to continue to be considered a critical technology in the updated List of Critical technologies in the National Interest.

ARTnet EOI – Executive Committee

ARTnet is looking for AANMS member representative on its Executive Committee.

ARTnet Call for EOIs
ARTnet_AANMS_Rep_EOI_Form_2022 (Word document)

Colleges

RACP

We are very pleased to advise that Nuclear Medicine has been accepted as part of the RACP Core Training Program. After a number of years of meetings/papers/lobbying etc

Our relationship with RACP is most definitely on the improve with the President Elect Prof. Jennifer Martin attending the AANMS Theranostics Course in August 2022.

RACP also supported our LuPSMA 1686 MSAC application by providing a letter of support.

We are submitting a proposal to the Committee for Combined College Training (CJCT) to have Theranostics included as part of NM Advanced training by 2023 (Legacy Provision aka “grandfathering”) and for inclusion into the next curriculum renewal which will be active by 2025 (Prospective Training). We are also providing support for Radiation Oncology access to NM training via the same 2-year pathway open to radiology trainees under the CJCT, but this will be sent to stakeholders in RANZCR for their agreement.

Lastly, we await the finalisation and signing of the updated Model of Collaboration (MoC) between the college and ourselves to formalise our standing within the RACP. we have been officially advised that nuclear medicine is now a three-month core training rotation for Basic Physician Trainees.

RANZCR

RANZCR
We continue to liaise with RANZCR regarding Training, with quite a number of EOI’s received from dual-trained RANZCR Fellows for the “RANZCR Fellow Representative” and “Recent Fellow Representative” on the Committee for Joint College Training (CJCT) in Nuclear Medicine. The successful Fellows are in the process of being notified, and all we know is that there was very high-quality competition for these positions this year. We will notify the membership as soon as the results are known.

The RANZCR is seeking members to join a new Nuclear Medicine Special Interest Group (SIG). The key objectives of the SIG are dealing with all aspects of nuclear medicine in radiology to keep the RANZCR updated with significant national and international policies and practices that are influential to patients in Australia and New Zealand and to advance professional expertise in nuclear medicine in Australia and New Zealand. Any interested members can still submit an expression of interest to standards@ranzcr.edu.au

Click here for more information.

And finally, the RANZCR Annual Scientific Meeting was held over the last weekend 29-30 October, at the Adelaide Convention Centre with a dedicated Nuclear Medicine Concurrent session on Saturday – with great speakers, including Dr Michael Kitchener, and other fellows Dr Felix Paterson and Dr Sonny Ho – and our recent theranostics article in the JNM was also discussed at a Radiation Oncology forum.

ANSTO

The Vice President, GM and I went to Lucas Heights at the end of May and met with the broader team. We have established regular meetings with the Executive and Policy, Corporate and Governmental Affairs team(s).

I have taken on the role on the Building 23 Development External Advisory Board.

Please see our recently published Sovereignty Position Statement here which was developed in collaboration with ANSTO as part of this new arrangement.

Media

There has been media interest in the MSAC LuPSMA submission with both Channel 9 and Channel 7 releasing written articles.

Please make sure you join our socials – AANMS has two twitter accounts – AANMS and Theranostics AANMS as well as our LinkedIn account. Click the link to join.

We now have over 1,000 Twitter followers. Please take the time to find, like and share our posts. All of the likes, shares and retweets help.

Please ensure you take the time to look at the increasingly new and improved website. We are adding resources regularly and working constantly at improvements – any feedback welcome.