Rebate reinstated

As of 1 March 2010, patients with wet macular degeneration (MD) who are receiving Avastin injections will again be entitled to a Medicare Rebate.

The Government’s decision to re-install Medicare benefits for Avastin injections will benefit those patients who do not have Age-relate sub-foveal MD and are thus not eligible to receive Lucentis on the Pharmaceutical Benefits Scheme (PBS).

The Medicare Rebate for Avastin was removed in November 2008 as the general definition of the term “therapeutic substance” was inserted in the Health Insurance Regulation. This meant that patients receiving Avastin injections could no longer receive Medicare benefits because Avastin had not been clinically trialed for wet MD.

Although Avastin has still not undergone full assessment for the treatment of wet MD and has not been approved by the Therapeutic Goods Administration (TGA), the Government has decided that it is in the best interest of patients to re-install the Medicare benefits for this treatment for a specific group of people.

Lucentis is still the preferred treatment for sub-foveal age-related MD in Australia and people should only be receiving Avastin injections if they are not eligible for Lucentis injections on the PBS.

Patients should have very clear information from their doctor as to what treatment they are receiving, the costs, safety and efficacy. The Foundation can help you with a list of the questions to be asked.

Please note that Avastin has not been listed on the PBS which means that patients will still need to pay the full cost of the drug.

In the first instance, if there are any concerns, the matter should be discussed with your eye specialist.

Posted: 26 February 2010