Lutetium-PSMA (Lu-PSMA) in the News

29 November 2022

An update on our Movember news item below:  the Herald Sun and the Daily Telegraph have each reported on Movember’s involvement with the AANMS and the introduction of Lu-PSMA, with a patient’s story to underscore the importance of access to this revolutionary treatment option.

Movember Supports Introduction of Lu-PSMA

28 November 2022

Movember, the leading charity changing the face of men’s health, is proud to be supporting the introduction of Lutetium-PSMA (Lu-PSMA) in Australia, working with the AANMS, the Australian Government and advisory groups.

Movember has just produced a press release that provides information about Lu-PSMA and the charity’s support; please click here to read.

Update – 2022 Federal Budget – Nuclear Medicine

11 November 2022

Following our email of 26 October announcing the Federal budget items for nuclear medicine, we now have further advice.

The Albanese Government’s first budget demonstrated that issues relating to nuclear medicine are on the Government’s radar. The key budget measures in nuclear medicine are as follows:

  • A$3.6 million over three years from 2023–24 to increase rebates for 6 nuclear medicine items (including Yttrium, Iodine, Phosphorous and SM Lexidronam) for patients receiving scans and treatment for illnesses, including cancer. Items as follows:

MBS Item                                                           Current Fee                New Fee

16003 Yttrium-90                                                $687.70                         $1,500.25

16006 Iodine-131 for thyroid cancer              $528.40                         $1,011.30

16009 Iodine-131 for thyrotoxicosis               $360.65                         $489.90

16012 Phosphorous-32                                     $312.00                         $2,813.80

16018 153 Sm-lexidronam                                $2,582.05                      $4,647.40

  • A$0.9 million in 2022–23 for additional costs associated with the procurement of the nuclear medicine Gallium-67, due to the significant price increase from the new supplier
  • A$0.1 million over three years from 2023–24 to amend patient eligibility for the current therapeutic nuclear medicine item for the treatment of painful bony metastases with any cancer type. This relates to the expanded indication for Strontium-89 to be used for all cancers (not just prostate cancer)
  • The Department of Industry and Science’s Portfolio Budget Statement confirms that in 2022-23, ANSTO will deliver the first stage of a multi-phased project for a new world-leading nuclear medicine manufacturing facility, as the existing facility is nearing the end of its useful life.

We are working closely with ministers and departments to ensure the focus on nuclear medicine remains strong whilst indexation is still outstanding.

2022 Federal Budget – Nuclear Medicine

26 October 2022

We have been working with the Department of Health on several items, that they have worked through the bureaucratic process, resulting in some relatively small wins for nuclear medicine in the budget announced last night (25 October 2022):

  • $3.6m over three years from 2023-2024, to increase rebates for six nuclear medicine items, including Yttrium, Iodine, Phosphorous and Samarium Lexidronam, for patients receiving scans and treatment for illnesses including cancer.
  • $0.9m in 2022-2023 for additional costs associated with the procurement of Gallium-67.
  • $0.1m over three years from 2023-2024 to amend patient eligibility for the current therapeutic  nuclear medicine item for the treatment of painful bony metastases with any cancer type.

This information is hot off the press from the budget last night, and we have met with the Department this morning (26 October), which conveyed its appreciation of the AANMS’s input and advocacy over the last six months, and more intense discussions over the last few weeks, to bring this result to fruition last night.

We are also pleased to announce that the Government will also provide $452m over six years from 2022-2023 to support the establishment of world class cancer centres in Brisbane and Adelaide.  The centres will provide multi-disciplinary cancer care, research and clinical trials for all types of cancers.

1 November MBS Changes

26 October 2022

The 1 November 2022 amendments to the Medicare Benefits Schedule are now available for review at the MBS Online.

These amendments include:

The introduction of new item number 61612 – Whole body FDG PET study for the initial staging of FDG-avid rare cancers.  We thank Andrew Scott, Fred Khafagi, Bill Macdonald, Stuart Ramsay and all those involved for their work in getting this new item onto the MBS.

For full details of the item descriptor and other requirements, please see pp.9-10 of the Quick Reference Guide.

The following are considered rare or uncommon cancer types:

anal cancer

bladder cancer

brain and other central nervous system (cancer of the)

brain cancer

gallbladder and extrahepatic bile ducts (cancer of the)

gastrointestinal stromal tumours (GIST)

Kaposi sarcoma

liver cancer

Merkel cell cancer

mesothelioma

multiple myeloma

ovarian cancer (incidence only)

ovarian cancer and serous carcinomas of the fallopian tube

pancreatic cancer

penile cancer

peritoneal cancer

placenta cancer

small intestine (cancer of the)

stomach cancer

testicular cancer

thyroid cancer

unknown primary site (cancer of)

uterine cancer

vaginal cancer

vulvar cancer

PET and Technetium 99-m changes for the amendment of three items (61333, 61336 and 61341) to provide patient access to alternative positron emission tomography (PET) imaging services during supply disruptions of the radiopharmaceutical technetium-99m. These were initially time-limited, but this has been lifted and they can be applied as soon as a shortage of Tc-99m has been identified, without going through the ministerial process.

The amended items are:

61333:  For full details of the item descriptor and other requirements, please see p.38 of the Quick Reference Guide.

61336:  For full details of the item descriptor and other requirements, please see p.39 of the Quick Reference Guide.

61341:  For full details of the item descriptor and other requirements, please see p.40 of the Quick Reference Guide.

Additional information:

Factsheet on 1 November MBS Changes

News Items – Lutetium PSMA and Prostate Cancer

31 August 2022

Two television channels have published news items to help publicise the urgent need for funding for LuPSMA for prostate cancer; the AANMS is a co-sponsor of an MSAC application for this item, which is still under consideration by MSAC.  You can read the articles here:

Channel 9 article

Channel 7 article

AANMS in the news

4 July 2022

The AANMS’s statements regarding PET PSMA funding have appeared in the news recently, including in the Health Industry Hub news and in Mirage News and The National Tribune.

AANMS Media Release:  PET PSMA Funding

1 July 2022

The AANMS has welcomed MBS funding for PET PSMA scans for men with prostate cancer.  This represents a major win for patients, who until now have had to either pay for this test themselves, or have been unable to obtain it due to costs.

The AANMS has worked closely with partners to achieve this important milestone in the diagnosis and treatment of prostate cancer.  The AANMS President, Associate Professor Sze Ting Lee, said, “We would like to acknowledge the work of Dr Robert Ware from Cyclotek in generating the original funding application and their ongoing support in steering the application with the AANMS during the tenure of my predecessor, Dr Geoff Schembri.  We also extend our thanks to all those who supported the application, including AstraZeneca who sponsored the application.”

The AANMS will work closely with other key stakeholders to ensure that patients are appropriately referred for these tests.  Read the full media release here.

AANMS Theranostics Position Statement in the News

7 June 2022

Congratulations and thanks (again!) to all involved with the development of the AANMS’s Theranostics Position Statement, that has just been published in the Journal of Nuclear Medicine which has promoted the Position Statement via Twitter.  A reminder that it is available for you to read/download here.

AANMS congratulates new Labor health team and calls for urgent re-indexation of nuclear medicine funding

3 June 2022

The AANMS welcomes the appointment of the Hon Mark Butler MP as Minister for Health and Aged Care, and the Hon Ged Kearney MP as Assistant Minister for Health and Aged Care.  To Association hopes to see progress on improving the access and affordability of nuclear medicine treatments for patients noting re-indexation of nuclear medicine on the MBS will be important in this regard.

Read the Media Release here.

New MBS Items

1 April 2022

PET for Rare and Uncommon Cancers

In a significant step forward in cancer diagnosis and treatment, we are delighted to announce the introduction of a new MBS item for positron emission tomography (PET) scans for initial staging of patients with rare and uncommon cancers. This new item will be introduced in the 1 November 2022 MBS.

Congratulations and thanks to Andrew Scott, Fred Khafagi, Bill Macdonald and Stuart Ramsay for a noteworthy achievement.

Substitute PET item for use during thallium-201 supply shortage

Effective 1 April 2022 to 30 September 2022, a new item (61644) is listed on the MBS as a temporary nuclear medicine diagnostic service.

This temporary item uses PET to assist with cardiac viability testing and is a direct substitute for MBS item 61325 which cannot be used due to a supply shortage of the radiopharmaceutical thallium-201.

Further information is available on the Factsheet.

AANMS Position Statement on Indexation

22 February 2022

The AANMS has updated its position statement on indexation (June 2022); you can view it here.

AANMS indexation campaign in the news

7 February 2022

The AANMS’s indexation campaign has been quoted in Health Industry Hub and the Financial Review.

AANMS calls for MBS indexation to be restored for nuclear medicine

31 January 2022

The Australasian Association of Nuclear Medicine Specialists (AANMS) recommends that the Australian Government urgently restores MBS indexation for nuclear medicine after a 23-year freeze.

In its 2022-23 Pre-Budget Submission, the AANMS has asked for a commitment from government to address the significant funding gap in nuclear medicine, to reduce out-of-pocket costs for consumers and ensure ongoing access to crucial nuclear medicine services.

View the AANMS’s submission here.

View the full media release here.

Australian Health Sector Women’s Leadership Summit

10 December 2021

Women & Leadership Australia is presenting the Australian Health Sector Women’s Leadership Summit, a major new online event for women leaders at all levels and across all facets of the health sector.  The Summit will be held on Friday 25 March 2022.

The Summit supports leadership development through strategic industry-based networking, targeted skills development and opportunities for leaders to share their experiences.  The Summit will also provide access to a group of women leaders and role models.

The interactive online event will feature keynote presentations, expert workshops, panel discussions, participant breakout sessions and discussion forums.

The Summit date and times are:

  • Friday 25 March 2022
  • Registration will commence at 08:40 (8.40am) AEDT
  • Sessions will conclude at 15:40 (3.40pm) AEDT

Registration:  the standard registration is $695 + GST, but the first 100 delegates to register will receive a Super Saver registration rate of $295 + GST.

Please go to the Super Saver link to register a Super Saver ticket.

View the Summit webpage.

Media release

3 December 2021

AANMS pays tribute to Health Minister Greg Hunt

The Australasian Association of Nuclear Medicine Specialists (AANMS) pays tribute to The Hon Greg Hunt MP, the Minister for Health and Aged Care, for his leadership of the Heath portfolio over the past five years and his decades of service to the Australian people. The AANMS is a representative body of medical practitioners working to promote and advance the practice of nuclear medicine for both diagnosis and therapy.

AANMS President, Dr Geoff Schembri, thanked Mr Hunt for his support to the nuclear medicine sector and his work to improve patient access to critical nuclear medicine services. In particular, the AANMS acknowledges Mr Hunt’s efforts in ensuring access to critical nuclear medicine procedures during a series of worldwide and national disruptions to nuclear medicine isotope supply over recent years. Mr Hunt also oversaw efforts to safeguard Australia’s sovereign capability to produce vital nuclear medicines with the launch of a $30 million project to design a new world-leading manufacturing facility at Lucas Heights.

“With over 700,000 nuclear medicine services delivered in Australia every year, the health of most Australians will benefit from nuclear medicine procedures in their lifetimes.” said Dr Schembri.

“It has been a pleasure working with Mr Hunt’s office during his time as Health Minister, and we wish him well in the next stage of his career,” Dr Schembri.

Media contact
Lisa Maddocks
CEO, AANMS
ceo@aanms.org.au

Safeguarding the Future of Nuclear Medicine Production

30 September 2021

The AANMS is pleased to advise that the Australian Government has today announced the launch of a $30 million project to design a new world-leading manufacturing facility to be built at Lucas Heights in Sydney.

Please see the Joint Ministerial media release from the Minister for Finance (Senator the Hon. Simon Birmingham), the Minister for Health (the Hon. Greg Hunt MP), the Minister for Energy and Emissions Reduction and Acting Minister for Industry, Science and Technology (the Hon. Angus Taylor MP).

This new facility will help address some of the recurrent production issues that have plagued our community in recent years by replacing the aged building 23. This is the facility that assembles, loads, tests and distributes a range of ‘finished’ nuclear medicine products, including 99Mo/99mTc generators.

This considerable achievement has been the result of many efforts within the nuclear medicine community, including direct lobbying by the AANMS President and former CEO in meetings with the Minister for Health and the then Minister for Industry, Science and Technology. We also acknowledge the efforts of the Nuclear Medicine Working Group that includes our AANMS representatives (Dr Elizabeth Thomas and our General Manager, Ms Lisa Maddocks) as well as representatives from ANZSNM and RAINS.

Our congratulations to all on a great achievement and we will continue to advocate for the interests of the Australian nuclear medicine community as this project develops.

New PET Item for Alzheimer’s Disease to be Introduced to 1 November 2021 MBS

30 September 2021

The AANMS is delighted to announce (as per the MBS Online November 2021 News) that a new item will be introduced to the 1 November 2021 MBS:

New item 61560 will be introduced for positron emission tomography for the diagnosis of Alzheimer’s disease.  The new item will allow patients with suspected Alzheimer Disease to access more effective diagnostic imaging where diagnosis through clinical evaluation is equivocal.

The Descriptor for the new item 61560 is:

FDG PET study of the brain, performed for the diagnosis of Alzheimer’s disease, if:
(a) clinical evaluation of the patient by a specialist, or in consultation with a specialist, is equivocal; and
(b) the service includes a quantitative comparison of the results of the study with the results of an FDG PET study of a normal brain from a reference database; and
(c) a service to which this item applies has not been performed on the patient in the previous 12 months; and
(d) a service to which item 61402 applies has not been performed on the patient in the previous 12 months for the diagnosis or management of Alzheimer’s disease.

Applicable not more than 3 times per lifetime

We congratulate Professor Chris Rowe for leading the charge on this for the last seven years, and thank him and his team at Austin Health for their efforts in obtaining this excellent outcome.

Thyroid International Recommendations Online (TIRO) – New Website Resource

30 September 2021

A new website has been produced by an international, multidisciplinary group of thyroid cancer specialists. It is a novel way to access clinical practice guidelines on thyroid nodule management and thyroid cancer care. In addition, these guidelines include updates afforded by video recordings that introduce new information that augment the material in the concise guideline presentations

The Thyroid International Recommendations Online (TIRO) is an easily accessible and contemporary hub of thyroid management guidelines that is an invaluable resource for those involved in the management of thyroid cancer patients. This platform was put together with the help of an international board of thyroid cancer specialists from Australia (A/Prof. Monica Rossleigh and A/Prof. David Pattison), Canada, France, Israel, Japan, Mexico, United States and the United Kingdom.

On this platform, the recommendations from major international medical societies in thyroidology have been summarised and compared with the intention to aid specialists to be able to provide guideline based care for their patients.

Additionally, TIRO provides educational content on a weekly basis in webinar format. These videos are archived and live in TIRO rounding out the content. These sessions expand on areas where recommendations are unclear, outdated and  where supporting evidence is not the best quality.

We invite you to browse the recently launched TIRO site at:  https://tiro.expert/.

New MBS Telehealth Inpatient Items – Commencing 15 September 2021

The AANMS has received the following advice from the Australian Department of Health concerning new temporary MBS telehealth inpatient items:

As part of the ongoing management of the COVID-19 pandemic, the Australian Government has approved a temporary expansion of the existing COVID-19 specialist telehealth items to include attendances for private admitted patients being treated in either a private or public hospital.

The expansion will occur through the listing of 40 new COVID-19 attendance items (20 telephone, 20 video) on the Medicare Benefits Schedule (MBS). The new items will commence from 15 September 2021.

The new items will enable admitted private patients to continue to receive essential Medicare services in circumstances where the admitting specialist medical practitioner’s access to the hospital is impacted by COVID-19 restrictions (as explained below).

The expansion will apply to a range of inpatient telehealth attendances provided by specialist medical practitioners in the following specialities – specialists; consultant psychiatrists; consultant physicians (including pain medicine, palliative care, sexual health and addiction medicine practitioners); public health physicians; neurosurgeons; anaesthetists; and approved dental practitioners – oral and maxillofacial surgery.

These changes, along with other temporary COVID-19 MBS telehealth items, will remain in place until 31 December 2021, with ongoing telehealth arrangements to be considered as part of broader Government consideration of MBS telehealth arrangements.

The following general conditions must be met in order to use the new telehealth inpatient items:

  • A private patient has been admitted to hospital; and
  • The admitting specialist medical practitioner, at the time the attendance is provided, is:

–       located in an area determined by the Commonwealth Chief Medical Officer to be a COVID-19 hotspot; or

–       required to isolate because of a State or Territory COVID-19 public health order; or

–       required to be in quarantine because of a State or Territory COVID-19 public health order.

The listing of COVID-19 hotspots by the Commonwealth Chief Medical Officer can be found on the Department’s website at areas of COVID-19 local transmission

MBS Benefits payable:

  • The new telehealth inpatient items attract a Medicare rebate of 85% of the MBS Schedule Fee.
  • Private health insurance benefits are not payable for these telehealth attendances.
  • Out of pocket costs for the new items will count towards the patient’s Medicare Safety Nets (original and extended).

Further information about the new arrangements is set out in the following attachments:

These information resources will also be available on the MBSOnline website (under Fact Sheets) from 15 September 2021.

If you have other questions about the new arrangements, please contact the Medical Specialist Services Section via email at: surgicalservices@health.gov.au.

CPD Changes Commencing 2023

7 September 2021

Members may be aware that that Medical Board of Australia has announced that there will be changes to CPD requirements commencing 1 January 2023.  The Medical Board will provide more information and guidance about what is changing and what you need to do to be ready for the changes in January 2023.  In the interim, you can check the Board’s information here.

The revised registration standard for CPD can be downloaded here:  Medical Board CPD Standard Effective 1 January 2023.

The Medical Council of New Zealand is also introducing strengthened recertification requirements; these can be downloaded here: MCNZ Recertification Requirements.

The MCNZ’s recertification and CPD information can be viewed here.

There are no changes to CPD standards or requirements for 2021 or 2022.  We understand that the medical colleges will be implementing changes to their CPD frameworks from January 2023.  For further information, please contact your college:

RACPhttps://www.racp.edu.au/fellows/continuing-professional-development

Australia: 1300 697 227 or MyCPD@racp.edu.au

Aotearoa New Zealand: 64 (0)4 460 8122 or MyCPD@racp.org.nz

RANZCRhttps://www.ranzcr.com/fellows/general/changes-to-cpd-requirements

Email:  cpd@ranzcr.edu.au

Phone – Australia:  Member surnames A – K  +61 (0)2 9268 9737  Member surnames L – Z  +61 (0)2 9268 9714

Phone – Aotearoa New Zealand:   + 64 (0)4 472 6470

Transfer of DI Accreditation Functions to the Australian Commission on Safety & Quality in Health Care

12 July 2021

The Australian Department of Health has advised that, further to a request from the Minister for Health and Ageing, it has been working with the Australian Commission on Safety and Quality in Health Care (the Commission), and consulting with key stakeholders, to transfer functions that support the pathology and diagnostic imaging accreditation programs to the Commission.

The Department and the Commission now have a formal arrangement in place to give effect to this transfer; this arrangement commenced on 1 July 2021.  The initial period will be an establishment phase, followed by the Commission providing:

  • continued support of the expert accreditation committees in the development and maintenance of accreditation standards and guidance,
  • operational oversight of accrediting agencies, and
  • advice related to accreditation standards.

The Department will retain policy and regulatory responsibilities associated with the accreditation programs.  For diagnostic imaging, Services Australia will continue to administer the Location Specific Practice Number (LSPN) Register.

For detailed information, please see the Department’s letter of 8 July 2021.

Revised AANMS Constitution and Member Code of Conduct

The AANMS’s revised Constitution and Member Code of Conduct were ratified at the Association’s Annual General Meeting held on 18 June 2021; pdf copies can be downloaded from the following links:

AANMS Constitution

AANMS Code of Conduct

Queen’s Birthday Honours 2021

The AANMS warmly congratulates the following Fellows who have received honours in the 2021 Queen’s Birthday Honours list:

Member (AM) in the General Division:
Dr John T Andrews VIC
For significant service to nuclear medicine, and to professional societies.

Medal (OAM) in the General Division:
Dr Alexander Douglas Levendel NSW
For service to cardiology and nuclear medicine

Among his many achievements, Dr Andrews is one of the founding members of the AANMS (formerly the ANZAPNM), and is a long-standing Honorary Life Fellow of the Association.

Dr Levendel has been a long-standing member/Fellow of the Association, and a Life Fellow since 2015.

AANMS 2021 Registrar Research Award Paper Published

21 June 2021

Congratulations to Dr Evyn Arnfield, winner of the 2021 AANMS Registrar Research Award, and colleagues for the publication of the Award-winning paper, “Clinical insignificance of [18F]PSMA-1007 avid non-specific bone lesions: a retrospective evaluation”, in the European Journal of Nuclear Medicine and Molecular Imaging.

To view the full paper, please go to https://rdcu.be/cmG0v (note this is a view-only copy).

To view the abstract with an option to purchase a copy of the paper, please go to HERE

AANMS submission to Review of Supervision of Nuclear Medicine Imaging, including PET services under Medicare, Discussion paper

In July 2020 the Department of Health released a discussion paper on the review of supervision of Nuclear Medicine imaging, including Positron Emission Tomography (PET) services under Medicare. AANMS consulted with members on the content of the AANMS submission and the responses to include in the consultation questions in the discussion paper.

The AANMS cover letter to the discussion paper is available HERE

The AANMS response to the consultation questions is available HERE

AANMS Pre-Budget submission on the economic case for indexation for nuclear medicine

2 February 2021

AANMS has made a submission to Federal Treasury as a part of the 2021-22 Federal Budget consultations. The focus of this submission from AANMS is on indexation for nuclear medicine and particularly the economic cost of the lack of indexation.

AANMS engaged Synergies Economic Consulting to develop the case for the Federal Government to restore indexation for Nuclear Medicine. Click on the link to access the report Economic cost of lack of indexation for nuclear medicine.

The lack of indexation of Medical Benefits Schedule (MBS) fees for nuclear medicine services since 1998 has meant increasing pressure on nuclear medicine providers as we struggled to provide contemporary and equitable services to our patients despite ever increasing across the board costs. While most imaging items received indexation last year, nuclear medicine was inexplicitly left out. After more than 20 years, indexation to cover the inflationary component of increased healthcare costs associated with salaries and wages, practice, and procedural costs is necessary to achieve the objectives of the MBS regarding supporting access to professional medical services.

The current policy freeze on indexation for nuclear medicine services means the burden of cost inflation for these set of services has been shifted onto patients and providers. Providers face the unpalatable options of limiting investment in their speciality, limiting provision of the more poorly renumerated tests or shifting the cost gap onto patients. This can make nuclear medicine procedures uncompetitive against better reimbursed tests, particularly when they can be bulk billed.

The report developed by Synergies Economic Consulting for AANMS does not provide a full financial assessment of indexation. The Government has the resources to undertake this, as has been done for the application of indexation for other areas of the MBS. The report demonstrates the case for the need for indexation by demonstrating the impact the lack of indexation is having on patients and the nuclear medicine profession.

The submission recommends that the 2021-22 Federal Budget commit resources through the Department of Health to undertake the work to determine the levels of indexation required and the timeframe for this to be applied, with this work to begin implementation in the 2022-23 Federal Budget.

Vale Professor Michael Quinlan AO

Physician and Nuclear Medicine Physician
(22.05.1938 – 02.10.2020)

Professor Michael Quinlan was a pioneer of Nuclear Medicine. He was the first Nuclear Medicine Physician in Western Australia, having trained in Nuclear Medicine at Johns Hopkins University, Baltimore under the guidance of Dr Henry Wagner. He worked initially at Royal Perth Hospital in the Department of Medical Physics and he then established the Nuclear Medicine Department at Sir Charles Gairdner Hospital in 1970. He later also established Nuclear Medicine at St John of God Hospital.

Professor Quinlan was committed to education and training, and he established the first Nuclear Medicine registrar training program in WA. He was a foundation member and committee member of the Australian and New Zealand Society of Nuclear Medicine (formed in 1969).

In addition to his commitment to Nuclear Medicine, he made significant contributions to many WA health organisations and universities including Notre Dame (Foundation Dean of College of Health 1999, Chancellor 2008-2011), Adjunct Professor at the University of Western Australia, Fellow of Royal Australian College of Physicians (awarded College medal 1998), Director of Medical Teaching Unit St John of God Hospital, Emeritus Consultant Sir Charles Gairdner Hospital. In 2018 he was awarded the Order of Australia for his work in medicine and clinical services.

Professor Quinlan had a lifelong commitment to medicine, particularly in teaching and education, however those that worked with him reflect on his genuine care and compassion for patients.

Professor Quinlan passed away after a brief illness in October 2020.

Ros Francis FRACP FAANMS, 14 January 2021

AANMS and ANZSNM submission to House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into the approval processes for new drugs and novel medical technologies in Australia

AANMS and ANZSNM made a joint submission to the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into the approval processes for new drugs and novel medical technologies in Australia.

The inquiry has a focus on the treatment of rare diseases and conditions where there is high and unmet clinical need. It consider s Australia continuing to be well positioned to access new drugs and novel medical technologies in a timely manner and respond to emerging global trends.

The joint submission noted Australia has an opportunity to develop a new industry of national significance and has the foundations for a very strong competitive advantage compared to other countries in the development of novel radiopharmaceuticals and theranostics. This could become a significant national industry generating economic returns, employment and expertise. It would also give Australian patients early access to the latest treatments in trials and novel therapies.

The submission also recommended consideration should be given to a new “class” of “drug” that is a “radiopharmaceutical”.

The submission is available to be viewed here HERE or on the Committee website HERE

Impact to ANSTO Nuclear Medicine Supply

18 November 2020

ANSTO have advised that there will be a delay in the restart of ANSTO’s OPAL reactor due to an anomaly identified in scheduled maintenance.  This will impact nuclear medicine product supply from 23 November 2020 onwards.

Some members may have already received an email communication from ANSTO.

The ANSTO website lists the affected products and has further details on the situation.

ANSTO have advised it will be at least four weeks before full domestic nuclear medicine supply is available.

ANSTO is currently working with the international nuclear medicine community to source supply of Molybdenum-99 and Iodine-131. However, from 30 November even if the supply is secured, they expect less than 50 per cent of usual supply.

The Nuclear Medicine Working Group has met to discuss the issue and the AANMS, ANZSNM and RAINS representatives have emphasised the importance of planning any supply reductions given the impacts on practitioners and patients.

ANSTO Customer Service will be in contact with customers to discuss a supply plan for 23 November onwards. The ANSTO customer service contact number is 1800 251 572.

Please check the ANSTO website for updates. AANMS will also provide members with any updated information that is available.

AANMS signs up to guide for empowering patients with information to understand medical costs

22 September 2020

The AANMS is a part of 12 medical groups who have joined the AMA and 16 existing leading medical organisations to sign up to a guide aimed at empowering patients with important information to understand medical costs.

Informed Financial Consent: A Collaboration Between Doctors and Patients is a guide that gives patients confidence to discuss and question fees with their doctors before treatment, lessening the chance of unexpected bills afterwards.

The guide is available here Informed-financial-consent-September 2020-v2

URGENT REVIEW NEEDED OF MEDICARE CARDIAC CHANGES

18 September 2020

The Presidents of peak medical associations have united to write to Health Minister Greg Hunt, calling for an urgent review of Medicare changes to cardiac diagnostic services that are leaving patients out of pocket and at risk of missing out on care.

The associations, representing GPs and other specialists, nuclear medicine specialists, pathologists, diagnostic imaging specialists, radiologists, and rural doctors, have told Minister Hunt that their advice was ignored when the changes were first proposed as part of the Medicare Benefits Schedule (MBS) Review.

“Patients who have previously received cardiac diagnostic services by a general practitioner, nuclear medicine specialist, or pathologist are either no longer funded to receive those services, will face higher out-of-pocket costs, or will only access those services in limited circumstances,” AMA President, Dr Omar Khorshid, said today.

“Coronary heart disease is the leading cause of burden of disease in Australia, and is higher in regional and remote areas than in major cities.

“Cardiovascular disease deaths are the greatest contributor to the mortality gap between Aboriginal and Torres Strait Islander Australians and other Australians.

“It makes no sense to make patients pay more, or have to be referred to a non-GP specialist, to have a basic heart test.”

Minister Hunt has indicated that some of the changes will be reviewed next year, but the Presidents said that will be too late.

“Several of the changes will significantly reduce patients’ access to prompt and appropriate cardiac diagnostic services,” the letter warns.

“These changes have occurred through a fundamentally flawed review, consultation, and implementation process.

“Insufficient regard was had for the range of other medical providers who are vital in providing comprehensive cardiac diagnostic services to patients.

“This includes general practitioners who are trained and experienced to provide the services that have now been restricted. They have a key role in being at the centre of a patient’s care, and enabling timely access to care.

“Nuclear medicine specialists and pathologists, including those within admitted hospital settings, are now also restricted from providing care that is accepted as clinical best practice and that supports and complements the services of cardiologists.

“We understand that you intend reviewing some of the cardiac diagnostic changes in six months’ time. In our view, this review will be too late.

“During this time, patient access to care will be compromised, and some patients will also face higher costs.

“Care that could easily be provided in a primary care setting will now need to be referred, and this will inevitably result in increased costs to the MBS.

“We know that access to non-GP specialist services in some rural and metropolitan areas is limited, and that the viability of some diagnostic imaging practices in these areas is also under threat.”

The signatories include the AMA, the Royal Australian College of General Practitioners (RACGP), the Australasian Association of Nuclear Medicine Specialists (AANMS), the Australian College of Rural and Remote Medicine (ACRRM), Australian Pathology, the Australian and New Zealand Society of Nuclear Medicine (ANZSNM), and the Australian Diagnostic Imaging Association (ADIA).

Background

  • On 1 August, the MBS replaced 18 cardiac test items and replaced them with 29 new items that changed which doctors can request tests, which tests they can provide, and for which patients.
    Since 1 August, patients attending their GP for an ECG will only be paid a Medicare rebate of $19 instead of the previous rebate of $32.25.
  • GPs will no longer attract a rebate for producing a report or a clinical note for the ECG trace.
    Almost all patients with suspected coronary artery disease must be referred for stress echo tests first, not a myocardial perfusion scan (MPS).
  • Stress echo tests may not provide the comprehensive information necessary for some groups of patients.
  • For medium-to-high risk patients, there will be a substantial increase in the volume of subsequent unnecessary and expensive tests, such as invasive coronary angiograms, to obtain the information that could have been acquired non-invasively using MPS.
  • Angiograms cost the health system an average of $1,500. Out-of-pockets for patients for the actual procedure are low – about $10 – however, they usually need to be admitted to hospital, so could be up for an excess payment to their insurer.
  • Nationally, in 2016-2017, 64 per cent of cardiac stress tests and imaging were requested by GPs, 26 per cent by cardiologists, and 10 per cent by other health professionals.

2020 AANMS Registrar Research Award – Winner Announcement

21 August 2020

The AANMS would like to congratulate to Dr Shyam Sankaran on winning the 2020 AANMS Registrar Research Award for his presentation Excellent suppression of physiological myocardial FDG activity in patients with cardiac sarcoidosis prepared with a 24-hour high fat very low carbohydrate diet and prolonged fasting.

Dr Sankaran undertook the research for this presentation while completing his first year of nuclear medicine training at The Alfred Hospital in 2019, and is currently completing his advanced training at Monash Health in Melbourne.

The AANMS would like to congratulate all the Award Entrants and acknowledge their work in applying and presenting. Thank you to the judging panel and all others involved.

The AANMS would also like to thank ANZSNM in providing the platform for the Awards and presentations, and in making the Annual Scientific Meeting possible via the online platform.

PET and the Comprehensive Facility Requirement

29 June 2020

The Australasian Association of Nuclear Medicine Specialists (AANMS)  has been made aware of several enquiries to the Department of Health regarding PET services.  The AANMS would take the opportunity to note that:

Clause 2.4.2 in the Diagnostic Imaging Services Table Regulations (DIST) requires Medicare funded PET services to be performed in a ‘comprehensive facility’. Comprehensive facility is defined in Part 3 of the DIST as ‘a facility where all of the following services are performed (whether or not other services are also performed) : PET, computed tomography, diagnostic ultrasound, medical oncology, radiation oncology, surgical oncology and x-ray’.

Further, clause 2.4.5 in the DIST requires the owner or operator of PET equipment to make a written declaration to the Chief Executive of Medicare that the place where Medicare funded PET services are provided, is a ‘comprehensive facility’. In making such a declaration, the owner or operator is asserting that all elements of the requirement have been met.

The intention of the ‘comprehensive facility’ requirement is to ensure that the services required for cancer diagnosis and treatment are provided in a location that allows patients to have access to high quality, multi-disciplinary care. Ready access to imaging, and the specialists reporting these images, facilitates the multidisciplinary team (MDT) process and allows for consistency of reporting and regular feedback.  Best practice for PET provision and interpretation is best achieved when the scans are able to be assessed in light of other relevant factors of patient history and treatment options.

To achieve this, PET services are hospital or cancer-centre based where there is a formal network of patient care. When the ‘comprehensive facility’ definition was reviewed in 2018 by the Diagnostic Imaging Clinical Committee (DICC) of the Medicare Benefits Schedule (MBS) Review Taskforce, the DICC agreed the definition should be retained to prevent the proliferation of low-quality PET services without the context of appropriate cancer service provision. The DICC also agreed that PET should be performed in a hospital setting with the involvement of the patient’s referring doctor where appropriate.

All Medicare funded diagnostic imaging services, including PET services must be rendered from a practice accredited under the Diagnostic Imaging Accreditation Scheme (DIAS).

Ultimately, it is the responsibility of individual business owners to undertake their own due diligence. If it is your intention to establish a practice providing Medicare funded PET services, you will need to ensure that the operational arrangements meet the legislative requirements.

The AANMS supports these measures which are designed to ensure best practice in PET service provision. We would also take the opportunity to strongly reinforce our support for personal supervision in nuclear medicine and PET and our belief that personal supervision provides a better imaging outcome and improved patient care.

AANMS Elects New President Dr Geoff Schembri

8 May 2020

On 8 May 2020 the AANMS held their Annual General Meeting. The meeting elected the new Board for the next two years – 2020-2022.

The New AANMS President is Dr Geoff Schembri FRACP FAANMS (NSW). Geoff was previously Vice President of the AANMS.

The AANMS Board members for 2020-2022 are:

President
Dr Geoffrey (Geoff) Schembri FRACP FAANMS (NSW)

Vice-President 
Associate Professor Sze Ting Lee FRACP FAANMS (VIC)

Honorary Treasurer 
Dr Michelle Nottage FRANZCR FAANMS (SA)

Immediate Past President 
Associate Professor Paul Thomas FRACP FAANMS (QLD) (ex officio)

DIRECTORS
Associate Professor Nathan Better FRACP FCSANZ FAANMS (VIC)
Dr Scott Beuzeville FRACP FAANMS (NSW)
Dr Samuel (Sam) McArthur FRANZCR FAANMS (VIC)
Dr Lisa Tarlinton FRANZCR FAANMS (NSW)
Dr Elizabeth Thomas FRACP FAANMS (WA)
Dr Eva Wegner FRACP FAANMS (NSW)

Therapeutic Goods Amendment (Radiopharmaceutical and Radiopharmaceutical Active Ingredients) Regulations 2020

In April the AANMS wrote to the Federal Minster for Health Greg Hunt requesting, under his powers in the Therapeutic Goods Act Section 18A Exemption because of emergency, to remove the current restrictions to supply within the same State or Territory, and also the restriction to only supply hospitals or public institutions.

On 2 May the Therapeutic Goods Amendment (Radiopharmaceutical and Radiopharmaceutical Active Ingredients) Regulations 2020 came into effect. The purpose of the Regulations is to enable public and private hospitals and public institutions that do not hold a manufacturing licence under the Act to manufacture radiopharmaceuticals or radiopharmaceutical active ingredients (RAI) for the treatment of a patient in another State or Territory, so that the radiopharmaceuticals or RAI can be transported to the patient in a timely manner. This eliminates the need for patients to travel interstate for diagnosis or treatment.

As AANMS advocated for, the exemption is necessary to facilitate the continued supply of radiopharmaceuticals to patients around Australia which has been negatively impacted by the unforeseen reduction in commercial flights between Australian capital cities caused by the COVID-19 emergency.

Where a hospital or institution is able to obtain sufficient supplies of radiopharmaceuticals or RAI from a manufacturer licensed under the Act, the radiopharmaceuticals or RAI should be obtained from that licensed manufacturer. The exemptions will apply for the duration of the COVID-19 outbreak.

See the full Explanatory Statement.

See the full Therapeutic Goods Amendment 2020.

MBS Diagnostic Imaging and Related Changes Effective 1 May 2020 – Item 61505 and PET

As the reimbursement rate for the PET item numbers was set prior to the PET/CT era, the AANMS has successfully made the case with the Department of Health that item 61505 should be extended to PET because of the additional time and cost of providing this service. Item 61505 will be co-claimable with PET items from 1 May 2020.

Item 61505 (CT scan performed at the same time and covering the same body area as single photon emission tomography for the purpose of anatomic localisation or attenuation correction where no separate diagnostic CT report is issued and only in association with items 61302 – 61650) has until now been limited to SPECT only.

Note that the existing DOTA PET item number currently includes the 61505 equivalent $100 fee and this items’ fee will be reduced by $100 to allow 61505 to be claimed with all PET studies, including the DOTATATE PET items.

For an overview of the changes go to Diagnostic imaging and related changes effective 1 May 2020

Australian Meetings – 2023

NOTE: We will continue to keep this list updated, but please check with the organising body before making any plans.

ANZSNM 53rd Annual Scientific Meeting
26 – 28 May 2023
Adelaide, South Australia
Website:  ANZSNM ASM 2023

ANZBMS Clinical Densitometry Course
4 – 5 March 2023 (face-to-face)
Melbourne – venue t.b.a.
Website:  https://www.anzbms.org.au/anzbms-bone-densitometry-course.asp

RACP Annual Congress
4 – 6 May 2023
Brisbane
Further details pending

CSANZ 71st Annual Scientific Meeting
3 – 6 August 2023
Adelaide Convention Centre, Adelaide
Website:  https://www.csanzasm.com/

RANZCR Annual Scientific Meeting 2023
19 – 22 October 2023
Brisbane Convention and Exhibition Centre, Brisbane
Further details pending


International Meetings – 2023

Nuclear Medicine Update 2023:  CALL FOR ABSTRACTS EXTENDED!

Join us for the Nuclear Medicine Update 2023 from 09 to 11 February 2023 in Singapore!
“Pushing The Boundaries of Theranostics”
Be part of the conference and submit your abstracts by 14 December 2022!
Click here for more information

SNMMI Annual Meeting
24 – 27 June 2023
McCormick Place, Chicago, USA
Website:  https://am.snmmi.org//iMIS/SNMMI-AM

EANM 36th Annual Congress
9 – 13 September 2023
Vienna, Austria
Website:  https://www.eanm.org/congresses-events/future-congress/