Minister announces two new listings on the PBS

Two major new listings on the Pharmaceutical Benefits Scheme (PBS) have the potential to extend the lives of Australians with advanced lung cancer and those at risk of a heart attack, saving patients almost $190,000 a year.

November is Lung Cancer Awareness Month and from November 1, patients with advanced lung cancer will have the treatment Keytruda^®subsidised for first-line treatment of metastatic non-small cell lung cancer (NSCLC).

Without PBS subsidy it would cost over $11,300 per script or $188,000 a year. Patients will now pay a maximum of $39.50 per script or just $6.40 per script for concessional patients, including pensioners.

This listing means that for the first time eligible patients with advanced lung cancer can avoid chemotherapy and be treated with this novel immunotherapy treatment Keytruda^®. It will benefit about 850 patients a year.

Keytruda® is an immunotherapy medicine working with a patient’s own immune system to recognise cancer cells and destroy them. Clinical trials of Keytruda® for lung cancer has shown that some patients became virtually cancer free after treatment.

This medicine is already listed on the PBS for classical Hodgkin’s lymphoma and unresectable Stage III or Stage IV malignant melanoma.

The Federal Government is also listing Repatha® from November 1 for the treatment of familial hypercholesterolaemia, which is a genetic high cholesterol condition.

More than 6,000 people with the condition, who are at risk of having a heart attack or stroke at an early age, will benefit from the treatment.

Patients would normally pay around $630 a script, or more than $8000 a year. With its listing on the PBS, eligible patients will pay a maximum of $39.50 per script for Repatha or just $6.40 with a concession card.

These listings with help the thousands of Australians and their families fighting lung cancer and the devastating impact of heart disease.

In announcing the new listings, Health Minister Greg Hunt said the Government was providing Australian patients with access to life-saving and life-changing medicines quicker than ever before.

“We are now making on average one new or amended PBS listing every single day,” Mr Hunt said.

“In the Budget we announced our commitment to invest $2.4 billion in new medicines to build on our commitment to guarantee those essential services that all Australians rely on.

“Our commitment to the PBS is rock solid. Together with Medicare, it is a foundation of our world-class health care system.”

The independent Pharmaceutical Benefits Advisory Committee (PBAC) recommended the listings that have been announced.

The Committee is independent of Government by law and in practice. By law, the Federal Government cannot list a new medicine without a positive recommendation from PBAC.

MoU heralds new research collaboration

An agreement signed between Australia and the Texas Medical Center (TMC) in the United States has opened the way for a new level of collaboration between world-class medical researchers from both countries.

The research agreement focuses on clinical trials and reaching high-level medical breakthroughs.

A Memorandum of Understanding (MoU) between the Federal Government and the renowned TMC was signed in Canberra late in October.

It will enable Australian medical researchers to better develop clinical practice and commercial opportunities in the areas of genomics, rare cancers, brain cancer research and current and emerging clinical trials.

Negotiations began in June this year, and Australia is now the first country to form such an agreement with TMC, home to the world’s largest children’s hospital and the world’s largest cancer hospital.

Health Minister Greg Hunt said the MoU demonstrates the Government’s commitment to supporting Australia’s world-class health system.

“It will provide economic opportunities and Australian patients could potentially be given earlier access to breakthrough medical technologies and treatment,” he said.

“Medical Research is currently a $1 billion industry in Australia and it is expected to triple in size, if not quadruple, in the next five years delivering huge economic outcomes, but more importantly lifesaving results.”

Lymphatic filariasis eliminated in more nations

Three more countries have wiped out lymphatic filariasis as a public health problem.

Palau, Vietnam, and Wallis and Futuna have eliminated lymphatic filariasis as a public health problem, bringing to 11 the number of countries and areas validated since 2000 in the World Health Organisation (WHO) Western Pacific Region.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and Regional Director Dr Shin Young-soo marked the accomplishment by presenting certificates to representatives from Palau, Vietnam, and Wallis and Futuna during the WHO Regional Committee for the Western Pacific held recently in Manila.

“We sincerely congratulate Palau, Vietnam, and Wallis and Futuna for eliminating lymphatic filariasis as a public health problem,” Dr Shin said.

“Decades of their effort with support from partners – including the governments of France, Japan, the Republic of Korea and the United States of America—as well as donations of medicines have enabled them to achieve this milestone and ensure future generations are safe from this dreadful disease.”

A mosquito-borne disease, lymphatic filariasis is one of 15 neglected tropical diseases that are endemic in the WHO Western Pacific Region. Also known as elephantiasis, the disease is painful and can lead to permanent disfigurement and disability, often causing people to lose their livelihood and suffer from stigma, depression and anxiety.

In 1997, the World Health Assembly resolved to eliminate lymphatic filariasis as a public health problem. In 2000, WHO launched the Global Program to Eliminate Lymphatic Filariasis by 2020. The program focuses on:

stopping the spread of infection through large-scale, annual treatment of all eligible people in affected areas; and
alleviating suffering by managing symptoms and preventing disability among people who are infected with lymphatic filariasis.

Since WHO launched program, a total of 11 countries and areas in the Western Pacific Region have been validated as having eliminated lymphatic filariasis as a public health problem: Cambodia, China, Cook Islands, Niue, the Marshall Islands, Palau, the Republic of Korea, Tonga, Vanuatu, Vietnam, and Wallis and Futuna.

Lymphatic filariasis remains endemic in 13 countries and areas in the Region: American Samoa, Brunei Darussalam, Fiji, French Polynesia, Kiribati, Lao People’s Democratic Republic, Malaysia, Federated States of Micronesia, New Caledonia, Papua New Guinea, Philippines, Samoa and Tuvalu.

Indigenous Medical Scholarship 2019

Applications are now being sought for the 2019 Australian Medical Association (AMA) Indigenous Medical Scholarship. Applicants must be of Aboriginal and/or Torres Strait Islander background.

Applicants must be currently enrolled full-time at an Australian medical school and at least in their first year of medicine. Preference will be given to applicants who do not already hold any other scholarship or bursary.

The Scholarship will be awarded on the recommendation of a selection panel appointed by the AMA. The value of the Scholarship for 2019 will be $10,000 per annum. This amount will be paid in a lump sum for each year of study.

The duration of the Scholarship will be for the full course of a medical degree, however this is subject to review.

Applications close 31 January 2019.

To receive further information on how to apply, please contact Sandra Riley, Administration Officer, AMA on (02) 6270 5400 or email indigenousscholarship@ama.com.au. An application package can be also downloaded from the AMA website www.ama.com.au/indigenous-medical-scholarship-2019.

The Indigenous Peoples’ Medical Scholarship Trust Fund was established in 1994 with a contribution from the Australian Government. In 2016, the Trust Fund became The AMA Indigenous Medical Scholarship Foundation. The Foundation is administered by AMA Pty Ltd.

If you are interested in making a donation towards the Scholarship, please go to www.ama.com.au/donate-indigenous-medical-scholarship.

The AMA would like to acknowledge the contributions of the following donors: Reuben Pelerman Benevolent Foundation; the late Beryl Jamieson’s wishes for donations towards the Indigenous Medical Scholarship; Deakin University; The Anna Wearne Fund and B B & A Miller Fund, sub-funds of the Australian Communities Foundation.

[Comment] Prevention, detection, intervention: the big wins for mental health

Around the world, media news bulletins and headlines are dominated by the health scourges of our time: cancer, diabetes, obesity, malaria, and heart disease. Governments rightly focus our international efforts on improving prevention, diagnosis, and treatment, and all are in the sights of clinical experts, scientists, and researchers who, with enough time, resources, and manpower, might just find a cure for them all.

Solution to mandatory reporting must not be second best

The AMA has called on Health Ministers to make sure the health of the nation’s doctors is not compromised by second-rate mandatory reporting laws.

The call comes as the Queensland Government prepares to introduce a Bill to the State Parliament in an attempt to address the issue.

The AMA has not been provided with the contents of the Bill, and fears that amendments sought by the AMA and many others were ignored by the COAG Health Council.

The Health Practitioner Regulation National Law Amendment (Tranche 1A) Bill, agreed by Health Ministers at the COAG Health Council on 12 October, must not be a second-best solution that may not protect the health of doctors, the AMA has warned.

AMA President Dr Tony Bartone said that the Health Ministers may believe they have made sufficient changes to the existing laws, but the AMA is adamant that its proposed amendments were vital to make the new national laws safe enough to give doctors confidence to seek help for their own health needs.

“Our fear is that the Bill going before the Queensland Parliament will stop doctors seeking health care when they need it,” Dr Bartone said.

“We fear that this Bill will not stop doctor suicides.

“Mandatory reporting affects every doctor, their families, their loved ones, their colleagues, and their patients.

“Our doctors desperately need legislation that does not actively discourage them from seeking medical treatment when they need it. Doctors are patients too. They should have the same rights to access confidential high-quality medical treatment as their own patients and all other Australians do.

“We urgently need a nationally consistent approach to mandatory reporting provisions. It will provide confidence to doctors. It will enable and empower them to seek treatment for their own health conditions anywhere in Australia.”

Dr Bartone said he could not understand why the COAG Health Council did not adopt the AMA recommendations and evidence in framing the new laws.

The AMA amendments were a minimum requirement since the Ministers refused to adopt the current successful and workable Western Australia laws, which will remain in place regardless of the COAG action.

The AMA has lobbied hard for changes to the mandatory reporting laws, including directly to successive COAG Health Council meetings and through lobbying of Ministers by State and Territory AMAs.

The changes need to be such that they will protect the health of doctors, which in turn will benefit patients.

[Comment] Offline: The fetishisation of “global”

Last week, the UK Government, WHO, and OECD came together to host the first Global Ministerial Mental Health Summit. The gathering, under the banner of “Equality for mental health in the 21st century”, felt a genuinely momentous event. Matt Hancock, Britain’s Conservative Secretary of State for Health and Social Care, spoke about “a bold and ambitious statement of intent”. Mental health was “a defining challenge of our age”. As machines take over what, in the past, have been considered cognitive tasks, human beings will be left to rely ever more on their emotional skills and abilities.

Commissioner appointed for aged care

Australia’s first Aged Care Quality and Safety Commissioner is a former acting head of Northern Territory Health Department.

Aged Care Minister Ken Wyatt has named Janet Anderson as the Commissioner. She will start her role as the sector’s regulator next year.

Mr Wyatt said the appointment marked a significant milestone in the journey towards a better, safer aged care system.

“Highly respected and experienced health sector leader Janet Anderson will oversee establishment of the Commission, as it prepares to start intensified compliance monitoring from 1 January 2019,” he said.

“The new Commission will have a budget of almost $300 million over four years, employing dozens of additional senior compliance officers.”

Ms Anderson was First Assistant Secretary, Health Services, in the Commonwealth Department of Health 2012-2015, and Director, Inter-Government and Funding Strategies in the New South Wales Department of Health 2006-2011.

For the past two years, Ms Anderson has held the positions of Deputy Chief Executive and acting Chief Executive of the Northern Territory Department of Health.

In 2009, she was awarded the Public Service Medal for outstanding work in health policy development and reform.

Ms Anderson was only recently appointed as the new head of ACT Health, but stepped down from the role almost immediately.

She is currently working with the NT Government to implement recommendations from the royal commission into the protection and detention of children in the territory.

Ms Anderson will be assisted by aged care medical expert Associate Professor Michael Murray, who is working as the new interim Chief Clinical Advisor to support key establishment activities.

Associate Professor Murray has a broad range of management, clinical and clinical teaching experience in aged care as the medical director of Continuing Care and head of Geriatric Medicine at Austin Health, Melbourne.

He is also the President of the Board of Directors at the National Ageing Research Institute, Associate Professor at Melbourne University and Adjunct Associate Professor Australian Centre for Evidence Based Aged Care and La Trobe University.

The permanent appointment of a clinical advisor to the Commission will be a matter for the new Commissioner.

The establishment of this agency is in addition to the recently announced royal commission into the aged-care sector.

Inquiry agrees with AMA’s aged care recommendations

A Parliamentary Committee report has accepted many of the AMA’s recommendations on how to improve the care of vulnerable Australians in residential aged care facilities, including the need for more registered nurses.

AMA President Dr Tony Bartone, who appeared before the Inquiry in May, said that the recommendations of the Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia largely align with AMA policy.

“It is critical that residents in aged care facilities, and the doctors visiting them, have access to appropriately trained staff at all times,” Dr Bartone said.

“The AMA has been advocating for a registered nurse-to-resident ratio that aligns with the level of care need, and ensures 24-hour registered nurse availability.

“The Committee has recommended that it be enshrined in law that all residential aged care facilities provide for a minimum of one registered nurse to be on-site at all times.

“This is a good first step. However, we recognise that one registered nurse will not be enough in many residential aged care facilities, which may have hundreds of frail residents.

“We are pleased that the Committee has further recommended that the Government specifically monitor and report on the correlation between standards of care, including complaints and findings of elder abuse, and staffing mixes to guide further decisions in relation to staffing requirements.

“In the most recent survey of AMA members who visit patients in residential aged care, more than one in three doctors said that they plan to cut back on or completely end their visits over the next two years, citing a lack of suitably trained and experienced nurses, and inadequate Medicare patient rebates.

“Our members are also concerned about the trend to replace registered and enrolled nurses with personal care attendants, who are not appropriately trained to deal with the health issues older people face.

“The Committee has acted on these concerns, recommending that the Government review the Medicare rebate for doctor visits to residential aged care facilities, and a review of the Aged Care Funding Instrument (ACFI) to ensure that it is providing adequate levels of care for the individual needs of aged care recipients.

“The AMA also notes the recommendation to improve the Community Visitors Program to ensure volunteers visiting aged care facilities are better able to respond to suspected abuse. The AMA Position Statement on Health and Care of Older People 2018 called for education and training programs on the recognition, intervention, and management of elder abuse.

“While we have a Royal Commission, the AMA still urges the Government to act as a matter of urgency in responding to the many reviews that have now been completed. We have seen too many cases of abuse and neglect to delay action any further. The need for access to appropriate quality care cannot continue to be left unaddressed.”

LUKE TOY and MARIA HAWTHORNE

The AMA Submission to the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia is at submission/ama-submission-house-representatives-standing-committee-health-aged-care-and-sport-%E2%80%93

The AMA Position Statement on Resourcing Aged Care 2018 is at position-statement/aged-care-resourcing-2018

The AMA Position Statement on Health and Care of Older People 2018 is at position-statement/health-and-care-older-people-%E2%80%93-2018

The AMA Submission to the Department of Health’s Draft Charter of Aged Care Rights is at submission/ama-submission-department-health-%E2%80%93-draft-charter-aged-care-rights

The AMA Aged Care Survey is at article/2017-ama-aged-care-survey

The AMA Position Statement on Health and Care of Older People 2018 is at position-statement/health-and-care-older-people-%E2%80%93-2018

The AMA Submission to the consultation on the Terms of Reference for the Royal Commission into Aged Care Quality and Safety is at submission/ama-submission-department-health-terms-reference-royal-commission-aged-care-quality-and

Funds injection to Indigenous health services

Facility upgrades and repairs are taking place to a number of Aboriginal and Torres Strait Islander health services across the nation, following a $2.7 million funding boost from the Federal Government’s Service Maintenance Program.

In total, 25 services across Australia will benefit in this round of upgrades.

Indigenous Health Minister Ken Wyatt said the funds had been allocated to improve the safety and accessibility of services in the Northern Territory, Western Australia, New South Wales, Queensland, Victoria and Tasmania.

“This includes vital support for clinics, accommodation and associated facilities, so staff can continue delivering comprehensive primary health care to First Nations people that is culturally appropriate and best practice,” he said.

“Our Government has given priority to services seeking urgent repairs and maintenance, especially facilities based in remote and very remote areas.”

The Service Maintenance Program – part of the Indigenous Australians’ Health Program (IAHP) – supports the improvement of health outcomes for Aboriginal and Torres Strait Islander people through better access to health services.

“Under the IAHP, we are committed to providing First Nations people with access to quality, comprehensive and culturally appropriate primary health care,” Mr Wyatt said.

The recent Federal Budget allocated $3.9 billion over four years to support Aboriginal and Torres Strait Islander health, an increase of about four per cent per year.

Significant projects in the current upgrade projects include:

Urgent security and safety upgrades to the Anyinginyi Health Aboriginal Corporation’s Men’s Health Clinic in Tennant Creek to include duress alarms and swipe cards;
Improving cultural appropriateness, safety and access at the Dhauwurd-Wurrung Portland and District Aboriginal Elderly Citizens Inc. clinic; and
Extending phlebotomy clean rooms at the Sunrise Health Service Aboriginal Corporation and the Maari Ma Health Aboriginal Corporation to allow immediate testing of children’s lead and iron levels.