UPFRONT

Just as Insight went to print, the AUSTRALIAN

SOCIETY OF OPHTHALMOLOGISTS,

(ASO) said claims public hospitals are resuming elective surgery in some states are misleading. Following a recent shutdown due to the Omicron variant, ASO president Associate Professor Ashish Agar said blanket announcements that elective surgery had restarted conveniently hides the fact many hospitals aren't doing so. “The fallout from the mismanagement of the pandemic response is far from over, with severe staff shortages, as well as burnt-out staff. Further, some of the largest hospitals remain under severe financial pressure, thus preferring to save money rather than treat patients,” he said. IN OTHER NEWS, Dr Theo Keldoulis, a past president of RANZCO, died at the age of 92. Keldoulis was considered instrumental in shaping the way ophthalmology was taught and practised in Australia. Before and after becoming college president in 1984-85, he served on numerous committees and was an early champion of his friend Professor Fred Hollows’ groundbreaking work with Indigenous communities, according to an obituary in The Age. Keldoulis died on 14 January and is survived by his wife Helen, three sons and a daughter plus an extended family spanning three generations. FINALLY, the ABC and SBS will receive additional funding to support audio description services for blind and vision impaired Australians. It comes after the Federal Government committed $4.2 billion for both public networks from 1 July 2022 to 30 June 2025. The ABC will receive $3.3 billion over the next three years, including $45.8 million under the Enhanced News Gathering program to strengthen local public interest journalism in regional communities. This is an increase of $87.2 million over the current triennium. The ABC will also benefit from a return of indexation on base operational funding as outlined in the May 2021 Budget papers.

■ WEIRD

Research has revealed everything humans see is a mash-up of the brain’s last 15 seconds of visual information. Academics from Aberdeen and Berkeley wrote in The Conversation they discovered that instead of analysing single snapshots, the brain pulls together objects to appear more similar to each other, creating the perception of a stable environment.

■ WONDERFUL

US regulators have approved new high-tech headlights that automatically tailor beams to focus on dark areas of the road and don’t create glare for oncoming drivers. The adaptive headlights are common in Europe, featuring LED lamps that can focus beams on darkness such as the driver’s lane and areas along the roadside.

■ WACKY

Prime Minister Scott Morrison hit back at critics following footage of him lifting his face shield while welding in the Northern Territory, risking flash burns to his eyes. “If all the narcs in the bubble want to have a crack at me, well, they can – but what I’m doing is showcasing the great work of our apprentices and small businesses,” he said.

STAT

CATARACT CARE

Only 4.1% of Australian ophthalmologists who responded to a survey said they offered simultaneous bilateral cataract surgery. Full report page 45.

WHAT’S ON

THIS MONTH AVC 2022

9 – 10 APRIL

The Australian Vision Convention 2022 clinical program provides a line-up of more than 30 world class speakers. infoqld@optometryqldnt.org.au

Complete calendar page 61.

NEXT MONTH OSHOW2022

27 – 28 MAY

One of Australia’s largest optical fairs showcasing the latest lenses, frames and equipment is returning to Sydney. marketing@odma.com.au insightnews.com.au

Published by:

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PRIVATE HEALTH HAS CONFIDENCE IN PROCESS

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those differences even if some refinement is needed. If important distinctions are abolished, then benefit levels will be reduced to the lowest common denominator, making it harder for companies to introduce and sustain innovation in the private system,” he said.

“If negative changes are made to the PL and patient access and doctor choice are not protected, this will devalue health insurance and result in increased pressures on our public health system.”

The government said consultation was being carried out with a Clinical Implementation Reference Group (CIRG), with stakeholder feedback for ophthalmic regrouping changes due mid-March.

Private Healthcare Australia (PHA) director of policy and research Mr Ben Harris said the organisation had confidence in the CIRG. He said Australians pay up to five times as much for some IOLs than in European markets, with the “supernormal” price of PL items a main contributor to rising premiums. (MTAA says rising costs are due to increased healthcare demands).

“For every dollar we are sending to a large multinational for a prosthesis is a dollar less we can provide to a hospital or doctor,” he said.

“The fundamental question is, do extra features provide benefit to the patient and are they already in the price of the device? Regrouping of items will be focused on the consumer and there will be competition for where various products can demonstrate their features are good for the consumer and are easier to use. The inflated prices we pay in Australia will provide room for companies to partake in that competition.”

The government said the CIRG would ensure there were no unforeseen clinical implications resulting from regrouping.

“Once finalised, the regrouping of the PL will undergo further review by the Independent Hospital Pricing Authority who will set the benefit for each item/group,” a spokesperson said.

“It is important to note the PL is a reimbursement mechanism and products not on the list will continue to be available in the private system. These reforms will not prevent clinicians from choosing the most clinically appropriate device for patients.”

DEMANDS ON INNOVATION Another part of the reforms pertains to overhauling the listing process for devices. The MTAA welcomed the proposed ‘abbreviated pathway’ as a new way “to expedite much-needed technologies to market”, which would relate to Class IIB and below devices (low to medium risk). IOLs usually fall under Class IIB, so highly similar lenses could theoretically not be subject to greater evidence levels and a faster process.

However, where there is some level of innovation, the MedTech industry is concerned about a potentially more involved health technology assessment process that would demand large data sets and complicated modelling more in line with MSAC and PBAC assessments.

SA cataract and refractive surgeon Dr

“GREATER REQUIREMENTS FOR EVIDENCE PRIOR TO BECOMING AVAILABLE ON THE PL COULD PUT AUSTRALIA INTO A SIMILAR SITUATION AS THE US”

BEN LAHOOD, OPHTHALMIC SURGEON Ben LaHood said Australian access to new ophthalmic products is among the best in the world. He acknowledged the PL was “massive, complex, and a burden to manage” and changes were required.

“But greater scrutiny and requirements for evidence prior to becoming available on the PL could put Australia into a similar situation as the US health system where FDA approval delays products by years and certain products simply are never approved,” he said.

“The flow on effects of this are greater than just Australian patients waiting longer for a certain product. These pipeline delays could lead industry to look elsewhere to launch products and put Australia in the ‘too hard’ basket. Costs of innovative technologies will skyrocket and smaller, innovative companies will be financially blocked from the market.”

Alcon Australia and New Zealand franchise head, surgical and country manager Ms Karen Fowler said the Australian ophthalmic community had raised concerns regarding the proposed reforms in recent months.

“I am aligned and fully support our industry partner, the MTAA’s position that the PL has ensured clinicians and patients have access to a comprehensive range of advanced and clinically effective medical devices,” Fowler said.

“Australian ophthalmic patients deserve the best care possible. The proposed PL reforms may lead to unintended consequences for ophthalmologists by limiting access to future innovation in the surgical eyecare space.” n

DIRECTOR REFLECTS ON CFEH ACHIEVEMENTS

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UNSW to continue his research and support his students," CFEH stated.

Kalloniatis’ departure and the strategic review come amid several other senior staff resignations, but CFEH has put this down to general staff movements. A project group across GDN, UNSW and CFEH named Horizon has been established to map the CFEH’s future strategy.

“We are all looking forward to exploring new joint initiatives to positively impact outcomes for the blind and low vision community, including in capacity development, innovation and placement opportunities for our workforce in eye health,” Ms Sarah Holland, executive manager of CFEH and member of Horizon, said.

“Though change is often unsettling, we are excited for the future of CFEH and look forward to working with our stakeholders and our community to positively impact the early detection space. Both GDN and UNSW are committed to ensuring the expertise developed at CFEH over the past 13 years continues to develop and has a positive impact on both patients and industry.”

Meanwhile, Kalloniatis said he was proud to have seen six PhD students graduate from their CFEH-based studies. Eight more are either under examination or well

Prof Michael Kalloniatis. into their research and thus more leaders will emerge with a CFEH-based research background.

“It’s also fantastic to see how sought-after our speakers to national and international conferences are, and to hear clinicians highly rate undergraduate students in terms of their knowledge of ocular imaging applied to eye disease after their CFEH rotations. The impact of CFEH education is at a local, national and international level,” he said.

“I thank all CFEH staff who have made the centre known nationally and internationally, and the board of CFEH and UNSW who have given me the opportunity to lead over the years. I look forward to my continued work within SOVS at UNSW.” n