The Federal Government has announced that from 1 July 2025, people receiving sight-saving eye (intravitreal) injections to treat macular disease will no longer receive health fund benefits for this treatment if it is performed in private hospitals and day surgeries#. Macular Disease Foundation Australia estimates that this will impact up to 12,200 patients*.
Instead, these people will need to start paying out-of-pocket costs to keep accessing eye injection treatment in private ophthalmology clinics, as public hospital eye injection clinics and bulk billing private ophthalmology clinics are either not available, or already at capacity.
Many people already feeling the cost-of-living pinch will now have another expense to add to their budget because they will no longer be able to claim their eye injection treatment under their private health insurance. Macular Disease Foundation Australia is concerned that this will force people to give up their treatment altogether because they will no longer be able to afford it.
We have previously said we would only support the reclassification of this MBS item if there had been a significant increase in the number of public outpatient clinics offering bulk billed eye injections to ensure improved access to affordable treatment. We know that the cost and affordability of treatment are still huge concerns for many people living with macular disease, and there are still limited options to receive bulk-billed treatments.
We have raised these concerns with the Minister for Health and Aged Care, Mark Butler’s office and will continue to do so.
As we head towards 1 July 2025, we must address the ongoing issue of lack of access to affordable sight-saving treatment in Australia, which the Government’s recent MBS decision only compounds. Solutions must be found to help ALL Australians living with macular disease who need eye injection treatment. It’s a significant issue that can no longer be ignored.
The Australian, State and Territory governments must step up to improve access to eye injections. As these injections are sight saving, more needs to be done to ensure these treatments are more affordable and accessible nationwide.
Our message for government is that investing in increased access to eye injection treatment for people with macular disease will not only save the sight of tens of thousands of people but will also save the government billions of dollars in the long term.
We call on the Australian Government to ensure adequate and equitable access to affordable intravitreal injection treatment across the country. This will require the Australian and State/Territory governments to work together to:
- Introduce an ophthalmology practice incentive to bulk bill eye injections for age pensioners with neovascular AMD.
- Ensure increased access to eye injection treatment in public hospital outpatient clinics which can only happen if state and federal governments work together.
- Establish partnerships between the public and private health systems to boost treatment access options for people needing intravitreal injections.
- Provide funding to help establish new ophthalmology clinics in areas of high demand for treatment, with agreements that these clinics will provide bulk billed eye injections.
The health and wellbeing of people with macular disease will always be Macular Disease Foundation’s main priority. Without treatment, people with macular disease will go blind. This is totally avoidable.
Media Statement attributable to Dr. Kathy Chapman, CEO, Macular Disease Foundation Australia.
References
* Calculation is based on MBS item data from Services Australia, Drug utilisation sub-committee (DUSC) data (most recent data is May 2018), and information sources from Services Australia, and data provided to Macular Disease Foundation by the Department of Health and Aged Care.
# People who have a specific medical reason for having intravitreal injections in a day surgery / hospital setting will not be affected by this change as an alternative MBS item is available in these cases
The current estimates of people receiving intravitreal injections in Australia are 62,000 people with neovascular AMD, 18,000 people with diabetic macular oedema and 11,000 people with retinal vein occlusion.
MEDIA CONTACTS:
Jonathan Abbott | Macular Disease Foundation Australia | Communications Manager
E: jon@mdfoundation.com.au | M: +61 413 995 189
The information provided in this release is provided by Macular Disease Foundation Australia located at Mezzanine Level, 383 Kent Street Sydney NSW 2000.
Posted: 15 October 2024
Saving sight will save billions of dollars
An investment to save the sight of thousands of vulnerable older Australians will save the Government up two billion dollars.