UPFRONT

Just as Insight went to print, GEORGE & MATILDA revealed two Queensland practices have joined its community. Medispecs North Lakes, north of Brisbane, and Atherton Optometrist, in the Queensland Tablelands Region, now join the more than 90 independents who have partnered with G&M. Founder and CEO Mr Chris Beer said more practices were expected. “As we begin to emerge, we are gearing up for our next wave of growth, with many of the country’s best independents now deciding now is the time to realise the value of their practice and benefit from the security and support we offer.” IN OTHER NEWS, a breakthrough bionic eye that delivers high-fidelity visual and spatial perception for the blind is one of 22 R&D projects to share in $47.1 million from the Federal Government. ARIA Research Pty Ltd has partnered with the University of Sydney, University of Technology Sydney and World Access For The Blind for the project. Valued at $9.6 million, it has been funded under the Cooperative Research Centre Projects initiative and received $2.6 million. If successful, the project could provide new levels of independence for the blind and vision impaired population nationally (600,000) and globally (over 337 million). FINALLY, new research commissioned by Vision Australia shows more than half of employers have never considered hiring a blind or low vision person. The survey of 1,003 employers – conducted by the firm EY Sweeney – also found many believed blind people would not be productive enough or thought they would be a financial burden. “We often hear from employers how they can’t find candidates who are qualified or committed, yet here we have evidence that employers aren’t even willing to consider a cohort of driven and talented candidates,” Vision Australia CEO Mr Ron Hooton said.

n WEIRD

Until now, stem cells from mammals, including humans, have been used in organoid research, but Heidelberg University researchers have demonstrated that stem cells from medaka and zebrafish can also form complex retinal tissue that can be cultured in a petri dish. Among other findings, the researchers expect to gain new insights into the basic mechanisms of retinal development.

n WONDERFUL

Microsoft has launched its Surface Adaptive Kit, a series of sticky labels that make it easier for vision impaired users to identify keys and important components such as USB ports and lightening cables. Even the packaging itself has been designed to be easy to open.

n WACKY

A new study investigating the way people visualise things they have already seen found many adults are resistant to imagining their own vision in 2D – seeing it in its fully processed, knowledge-laden form instead. “The next question to ask is why did these people think in that way? Is it that they could not think in 2D, or that they chose not to?” the authors asked.

STAT

OCULAR TRAUMA

Eye injuries led to more than 86,000 emergency department presentations in 2013-15 in Australia and over 51,000 hospitalisations. Image: LEI/Chris Barry. Full report page 45.

WHAT’S ON

THIS MONTH ORTHOPTICS AGM

NOVEMBER 20

The 2021 Annual General Meeting of Orthoptics Australia is taking place online at 10.30am AEDT. office@orthoptics.org.au

Complete calendar page 57.

NEXT MONTH APVRS CONGRESS

NOVEMBER 19 – 23

The 14th Asia-Pacific Vitreoretina Society Congress will be held virtually, bringing the latest developments in the field. secretariat@apvrs.org insightnews.com.au

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SPLITTING PAYMENTS A 'BLIGHT' ON SYSTEM

continued from page 3

and, if so, will they allocate just a small amount of money which is not viable in a business sense? Or are they going to cut out the payment altogether, presumably passing the cost to day surgeries or doctors – none of that we know.”

He said private health insurance “would become a joke” if insurers decided to pick apart surgeries and decide which parts to fund. He believed all stakeholders would be better off reviewing each component that determines the funds paid to day surgeries, and setting agreed fees.

According to the government, to ensure clinicians and patients still have access to the de-listed items such as intraocular fluids, insurers and hospitals are working together to agree on an alternative funding arrangement.

“It is expected that market competition and direct contracting will result in more efficient prices and contracting arrangements. The government has an expectation that for those items removed, insurers and private hospitals will reach an agreement on a market based alternative funding arrangement and one that does not involve out-ofpocket costs for the consumer,” the consultation paper stated.

“Some devices that are accessories intended to be always supplied and used together with an implantable or surgically invasive device will no longer be separately funded through the PL. Instead, it is anticipated their cost will be bundled into the cost of the device they are intended to be used with or funded under a different funding mechanism.”

Sumich said the ASO was also against bundling items, which was another example of health funds wrestling control and finding cost savings that could impact the financial viability of day surgeries.

“When items are bundled, all they do is combine a couple of items together and cut the cost of both to save money,” he said. “You may choose a certain fluid to go with an IOL due to its properties and fact it suits your technique, but once they start bundling, it is taking control of what you are choosing, which is being determined by what [health funds] are prepared to pay for.”

AN ‘INSIDIOUS’ PRACTICE Private Healthcare Australia (PHA) – representing 23 health funds – said the consultation paper did not seek a debate on the merits of items. Instead, it was discussing how these items would be paid for – as part of a government-controlled mandated price list or through market mechanisms. The lobby group said consumables and surgical instruments such as intraocular dyes were generally already included in existing banding or bundled payments, and hence should not be included.

“Splitting devices to maximise revenue is a blight on the current system. It disadvantages consumers, who pay more than necessary, and it disadvantages manufacturers who do the right thing. Any future medical device reimbursement system must stamp out this insidious practice,” the organisation stated.

“PHA supports the proposal that devices that are essential and specifically designed as a single-use aid for implanting a prosthesis, or are critical for maintaining ongoing-function of the surgically implanted prosthesis, should be bundled into the price of the device. In many cases, bundling items will involve summing of the current reimbursement, but in many other cases, bundling will in effect remove items and simply change the description of the main device.”

PHA stated that consumable items which are removed from the PL from 1 February 2022 would continue to be funded by private health insurance, however it did not state to which degree.

“The benefits of reform will be shared by consumers and hospitals. Private health insurers have committed to pass on savings to their customers.” n

"WHAT STARTED AS A PROSTHESIS REVIEW HAS BROADENED INTO A COST CUTTING EXERCISE INCLUDING INTRAOPERATIVE FLUIDS"

PETER SUMICH, ASO

THERAPY A WELCOME ADDITION TO DRY EYE TOOLKIT

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men, especially women who were older, and peri- and post-menopausal.”

Increased screen time, air conditioning use, and mask associated dry eye (MADE) during the pandemic, will likely increase DED prevalence, Watson added.

According to Seqirus, patients with severe keratitis are at heightened risk of infection, vision loss, and impaired quality of life. Tear film instability, and reduced tear production can create a cycle of hyperosmolarity, ocular inflammation (including keratitis), and apoptosis, causing damage to the ocular surface.

UNSW clinical scientist and president of the International Society for Contact Lens Research Scientia Professor Fiona Stapleton said ongoing exposure to inflammatory mediators, and a hyperosmolar tear film, resulted in recurring damage to the ocular surface. In most cases, severe symptoms of discomfort and variable vision will significantly impact quality of life.

Further, Seqirus stated conventional aqueous solutions are limited to watersoluble molecules. Within two minutes of instillation, more than 80% is eliminated via the nasolacrimal drainage system, limiting residence time on the ocular surface.

“A topical formulation that remains longer on the ocular surface, and provides sustained therapeutic concentrations, is a welcome treatment option for those living with severe keratitis associated with DED who have not responded to other treatment options,” Stapleton said.

Prof Stephanie Watson.

“Cationic emulsions with an oily core offer an alternative formulation to deliver lipophilic drug substances with poor water solubility, such as ciclosporin, to the eye. Emulsions provide a high encapsulation rate, enhanced stability of the active ingredient, and improved residence time."

Seqirus head of medical affairs for the international region, Dr Jonathan Anderson, said the company was excited about introducing its second PBS listed eyecare product this year.

“Seqirus is committed to broadening access to eyecare products to help address unmet clinical needs,” he said. “The PBS listing of Ikervis for severe keratitis in adults with DED, will give Australians access to affordable treatment options that have long been available overseas.” n