Push to align MBS rebate for liver fibrosis test

A liver fibrosis assessment would attract a significantly smaller rebate in general practice compared to scans carried out by non-GP specialists under a new application being reviewed by the Medical Services Advisory Committee (MSAC).
 
The proposal to add Vibration-Controlled Transient Elastography (VCTE) to the MBS is currently being considered by MSAC, a Government-appointed committee advising on funding for health services and technologies.
 
The technology is described by the applicant as a ‘a non-invasive diagnostic tool that assesses the extent of liver fibrosis’ in patients with metabolic dysfunction-associated fatty liver disease (MAFLD).
 
The application, carried out on behalf of Medical Technologies Australia, proposes two MBS items with identical schedules, with a rebate of $101.70 if the technology is used in general practice and $141.75 among non-GP specialists.
 
The discrepancy is noted in RACGP correspondence sent to MSAC this month.
 
‘The fee for specialist GPs should be in line with the fee for other specialists, given they are expected to undertake the same tasks as per the descriptor,’ RACGP President Dr Michael Wright states in a letter written in response to the application.
 
‘As such, the RACGP does not currently support the proposed GP fee unless this is commensurate with a non-GP specialist fee.’
 
However, the RACGP expresses its broader support for the use of the technology, citing the prevalence of MAFLD at an estimated one in every three Australian adults.
 
‘If widely implemented, this technology will provide people living with MALFD better and more equitable access to assessments that will improve their care,’ the letter states.
 
It also notes that buying the equipment ‘requires a significant financial investment’ and warns that general practices in regional, rural and remote areas ‘may find it cost prohibitive’.
 
The technology measures liver stiffness by generating a mechanical pulse that creates a shear wave through the liver tissue.
 
According to the application, the result of the process is ‘superior to ultrasound’ and ‘correlates strongly with the degree of liver fibrosis and is highly accurate in identifying advanced fibrosis and cirrhosis’.
 
Last year, the RACGP backed a Gastroenterological Society of Australia consensus statement on the assessment of MAFLD in primary care.
 
That statement recommends a VCTE scan for MAFLD patients every three years.
 
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