MedicalServicesAdvisoryCommittee

PublicSummaryDocument

ApplicationNo.1143–RadiofrequencyAblationforthetreatmentof

Barrett’sOesophagus

Applicant:DeviceTechnologiesAustraliaPtyLtd

DateofMSACconsideration:51stMSACmeeting,2December2010

1.PurposeofApplication

On13October2009,DeviceTechnologiesAustraliaPtyLtdrequestedthatMSACundertake anassessmentofRadiofrequencyAblation(RFA)forthetreatmentofdysplasticBarrett’s Oesophagus(BO).

MSACnotedthatBOwithlow-gradedysplasia(LGD)istreateddifferentlytoBOwith

high-gradedysplasia(HGD),duetothedifferentratesofprogressiontooesophagealcancer. MSACconsideredthestrengthoftheevidenceinrelationtoRFAinthetreatmentofBO separatelyforLGDandHGD.

2.Currentarrangementsforpublicreimbursement

RFAisgenerallyprovidedasadayprocedureperformedunderconscioussedationinan outpatientsettingbyagastroenterologistorsurgeontrainedintheprocedure. RFAforthe treatmentofBOisnotcurrentlylistedontheMBS.

ThefeeforMBSitem30479wasconsideredbyMSACtoaccuratelyreflectthetimeand expertiserequiredtoperformRFAandwasthereforeusedintheeconomicevaluationofthe procedure. Atthetimeofthisappraisal,thisitemattractedafeeof$458.05. Theexisting descriptorforMBSitem30479is:ENDOSCOPYwithLASERTHERAPYorARGON PLASMACOAGULATION,forthetreatmentofneoplasia,benignvascularlesions,strictures ofthegastrointestinaltract,tumorousovergrowththroughoroveroesophagealstents,peptic ulcers,angiodysplasia,gastricantralvascularectasia(GAVE)orpost-polypectomybleeding,

1ormoreof.

Theapplicantproposedafeeof$1,330forthisprocedurebasedonthefeefortheMBSitem fordouble-balloonenteroscopy. NoMBSdescriptorwasproposedforthisprocedure.

Thecomparatorsfor RFAfor BOwithLGDareconservativetherapy(acidsuppressionand surveillance)andargonplasmacoagulation(APC). Thecomparatorsfor RFAfor BOwith HGDareAPC,endoscopicmucosalresection(EMR)andoesophagectomy.

TheprimaryMBSitemforconservativetherapyis30473,whichhasafeeof$170.40. The itemdescriptoris:

OESOPHAGOSCOPY(notbeingaservicetowhichitem41816or41822applies), GASTROSCOPY,DUODENOSCOPYorPANENDOSCOPY(1ormoresuch procedures),withorwithoutbiopsy,notbeingaserviceassociatedwithaserviceto whichitem30476or30478applies

TheprimaryMBSitemforoesophagectomyis30535,whichhasafeeof$1,632.35. The itemdescriptoris:

OESOPHAGECTOMYwithgastricreconstructionbyabdominalmobilisationand thoracotomy

MSACnotedthatneitherAPCnorEMRarecurrentlyfundedontheMBSforthetreatment ofBO.

3.Background

Barrett’sOesophaguswithDysplasiaisaconditionresultinginametaplasticchangetothe liningoftheoesophagus,suchthatthenormalsquamousepitheliumisreplacedbycolumnar epithelium. Thedisorderseemstobeacomplicationofchronicgastro-oesophagealreflux disease(GORD),althoughasymptomaticindividualsmightalsobeaffected,anditisarisk factorforthedevelopmentofoesophagealadenocarcinoma,acancerwithrapidlyincreasing incidenceindevelopedsocieties.

Althoughthenaturalhistoryofthediseaseisnotfullyunderstood,thebiggestriskfactorsfor progressiontocancerarethelengthoftimewithabnormalmucosaandthedegreeof dysplasia. Expertpathologistscandifferentiatebetweenlowgradedysplasia(LGD)andhigh gradedysplasia(HGD). HGDisgenerallyacceptedasaprecursortooesophagealcancer whichcarriesapoorprognosis,butnotallpatientswithLGDprogresstoHGD.

ThepurposeofRadiofrequencyAblation(RFA)istothermallydestroydysplasticmucosa, allowingforre-epithelialisationwithhealthysquamousepithelium.Initially,asizingballoon is usedtomeasurethediameteroftheoesophaguswhilstthepatientisunderconscious sedation. Anappropriatelysizedradiofrequencyballooncatheteristhenintroducedovera guidewireinaside-by-sidemannerwithanendoscope.Thecatheter’sballoonistheninflated andradiofrequencyenergyapplied,circumferentiallyablatingtheepitheliumofthe oesophagustolessthanonemillimetre.Theablatedepitheliumisthenremovedbythe clinicianusingirrigation,suctionandlightpressure. Oncedysplasiahasprogressedto adenocarcinoma,invadingtodeeplayers(laminapropriaorbeyond),oesophagectomyisthe treatmentofchoicetoensurenopotentiallymalignantcellsremaininanycelllayer.

MSACconsideredthatinatypicalyearofRFAtreatment,thefollowingMBSitemswould beclaimed(ifRFAwaspubliclyfunded):

•30479/newitem–RFA(x3)

•30473–Oesophagoscopy

•20740–Anaesthesia(x4)

MSACagreedthattheaccuratediagnosisofdysplasticBarrett’sOesophagusisanimportant anddifficultstepinthetreatmentalgorithm,andnotedexpertadvicethattwoexperienced pathologistsshouldconferonthefinalgrading. MSACconsideredthatthechoiceof treatment shouldbeoverseenbyamulti-disciplinaryteamand,ifconsideredappropriatefor thepatient,RFAshouldbeperformedbyanappropriatelytrainedspecialistgastroenterologist orsurgeon.

RFArequiressimilartimeandexpertisetoendoscopiclasertherapyorAPC,whicharelisted ontheMBSunderitem30479. TheinclusionofRFAforBOwitheitherLGDorHGDon theMBSwouldrequireamendmentofMBSitem30479orthecreationofanewitem.

Inaclinicalsetting,RFAforLGDandHGDisundertakenoncedysplasticBOhasbeen confirmedbypathologytesting.

MSACnotedexpertadvicethattwoexperiencedpathologistsshouldconferonthefinal gradingofBO. MSACagreedthatprofessionalbodiesshouldbeinvolvedindeveloping standardsforboththediagnosticprocessaswellasfortheconductoftheprocedure.

4.Clinicalneed

MSACnotedthatbothLGDandHGDBOcanbetreatedwithcurrentlyfundedservices. It notedthatoesophagectomyistheonlytreatmentcurrentlyfundedforHGD,whichisan invasiveprocedurewith30-50%morbidityandaround2%mortalityintheAustraliansetting.

MSACnotedthatoncedysplasiahasprogressedtoadenocarcinoma,invadingtodeeplayers (laminapropriaorbeyond),thenRFAisnotindicated.Rather,anoesophagectomyisthe treatmentofchoicetoensurenopotentiallymalignantcellsremaininanycelllayer.

MSACnotedthatanestimated100patientsper yeararediagnosedwithHGDinAustralia, withanaverageageatdiagnosisof60. Approximately300patientsperyeararediagnosed withLGD.

MSACalsonotedthattherearelimiteddataavailableregardingtheprevalenceofBarrett’s OesophagusinAustralia. However,therehasbeenanincreaseinthefrequencyofdiagnosis ofBarrett’sOesophagusfrom2.9to18.9per1000endoscopiesbetween1992and2002, althoughthesedatadonotspecifytheseverityofdiseaseorlevelofdysplasia.

5.Comparator

MSACnotedthatBOwouldbediagnosedduringanendoscopy. FollowingdiagnosisofBO, thepatientwouldreceivemultipleendoscopicbiopsieswhichwouldthenbegradedby experiencedpathologists. Aconfirmeddiagnosisofdysplasiawouldresultintreatmentbeing undertakendependingonthegradingofthedysplasia;RFAwouldbeoneoptionfor treatment.

ListingofRFAontheMBSwouldresultinsomeinstancesofRFAbeingusedinsteadof conservativetherapyorAPCinthecaseofdiagnosedLGD;oroesophagectomy,APCor EMRinthecaseofdiagnosedHGD. MSACthereforeagreedthatconservativetherapyand APCweretheappropriatecomparatorsforLGDBO;andthatoesophagectomy,APCand EMRweretheappropriatecomparatorsforHGD.

Photodynamictherapyisanotherablativetechniqueusedinternationallytotreatdysplastic BO. Thetechniqueemploysphotosensitisingagentswhichareingestedbythepatient. MSACdidnotconsiderphotodynamictherapyasacomparatorbecauseitisnotusedin Australia,asexposuretolight(particularlysunlight)cancauseseriousadversereactionsfor manydaysfollowingtreatment.

6.Scientificbasisofcomparison

TheprimarysourceofevidenceforMSAC’sadvicewasanassessmentreportproducedby contractedevaluators. Theassessmentreportcomprisedofascientificliteraturereviewthat wasinformedbyanadvisorypanelofclinicalexpertsandaconsumerrepresentativewho ensuredthattheassessmentconsideredrelevantconsumerissuesandappropriatelyreflected theAustraliansetting.

Thefindingsofonerandomisedcontroltrial(RCT),fivecaseseries,twohealthtechnology assessments,threesetsofguidelinesandfourreviews(includingtwoCochranereviews)were includedintheassessmentreport.

Fiveofthesixavailablestudies,includingoneRCT,mettheinclusioncriteriaforassessment ofsafety. MSACnotedthattheselimiteddatawerenotcomparative,whichpreventeda directcomparisonofthesafetyofRFAwithotheravailabletreatments.

Sixstudies,includingoneRCT,mettheinclusioncriteriafortheassessmentofeffectiveness. MSACnotedthatthelimitedstudiesshowedonlyshort-termdata,withamaximumof24 monthsfollow-up. MSACfurthernotedthatalackofcomparativedatapreventedtheclinical effectivenessofRFAbeingdirectlycomparedtootheravailabletreatments.

7.Safety

MSACnotedthattheliteraturereportedfewmajorcomplicationsfollowingmultiple treatmentsessions. Mostadverseeventsreportedwereminorandresolvedwithout intervention.

MSACagreedthatthelimitedevidencesuggeststhatRFAissafeforthetreatmentof Barrett’sOesophaguswithdysplasiaand/orearlyintra-mucosalcancer(IMC). However, lack ofcomparativedatapreventedthesafetyofRFAbeingdirectlycomparedtoother treatmentsavailableforpatientswithLGD,HGDandintra-mucosalcarcinoma(IMC). Asa result,conclusionscannotbedrawnastowhetherRFAissaferthansurveillanceorAPCin patientswithLGD. Inaddition,limitationsintheliteraturealsopreventedthecomparisonof thesafetyofRFAtoAPC,EMRoroesophagectomyforpatientswithHGDandIMC. However,MSACacceptedthatRFAhadlowermorbidityandmortalitythan oesophagectomy.

8.Clinicaleffectiveness

MSACnotedthattheRCTreportedthefollowingeradicationofintestinalmetaplasiaand dysplasiafollowingRFAforLGD:

RFA / Control / pvalue
CR-IM% / 81 / 4 / 0.001
CR-D% / 90 / 23 / 0.001

* CR-IM:completeeradicationofintestinalmetaplasia

*CR-D:completeeradicationofdysplasia

MSACnotedthattheRCTreportedthefollowingeradicationofintestinalmetaplasia followingRFAforHGD:

RFA / Control / pvalue
CR-IM% / 74 / 0 / <0.001

* CR-IM:completeeradicationofintestinalmetaplasia

MSACalsonotedthattheincidenceofsubsquamousintestinalmetaplasiawaslowerinthe

RFAgroupthanthecontrolgroupforLGDandHGD.

Inthenon-RCTstudies,completeeradicationofintestinalmetaplasiawasreportedin54-79%

ofcases,andcompleteeradicationofdysplasiawasreportedin80-100%ofcases.

ThelimitedliteraturesuggestsRFAiseffectiveforachievinghistologicaleradicationof intestinalmetaplasiaanddysplasiaatamucosallevel. Lackofcomparativedataprevented theclinicaleffectivenessofRFAbeingdirectlycomparedtootheravailabletreatments. Asa result,MSACcouldnotconcludewhetherRFAisaseffectiveormoreeffectivethan surveillanceorAPCinpatientswithLGD. Similarly,MSACwasunabletoconclude

whetherRFAislessormoreeffectivethanAPC,EMRoroesophagectomyinpatientswith

HGD.

MSACfoundthelengthoffollow-upstudies,rangingfrom11-24monthsintheincluded studies,wasinsufficienttodeterminelong-termsuccessincancerprevention.

MSACnotedtheexactincidenceofBOwithdysplasiainAustraliaisuncertain. Italsonoted alackofevidenceontherateofprogressionofLGDtoHGD.

9.Economicevaluation

Therewassufficientevidencetoconductafullcost-effectivenessanalysisofRFAforthe treatmentofLGD.Adecisionanalyticmodelwasdeveloped,whichprovidesaframework fordecisionmakingunderconditionsofuncertainty.Theeconomicevaluationestimatedthe incrementalcost-effectivenessofRFAcomparedtosurveillance.

MSACnotedtherewasinsufficientcomparativedataavailabletoconductacost- effectivenessanalysisonRFAforHGD,thereforeacostanalysiswasconductedtocompare thedifferentcostsassociatedwiththeprocedureanditscomparators.

MSACfoundthatreplacingsurveillancewithRFAforLGDwouldyieldanadditional benefitof0.129QALYsatanadditionalcostof$10,175. Thisresultedinanincremental cost-effectivenessratio(ICER)forRFAcomparedwithsurveillanceof$78,975perQALY.

Themaindriversofthecost-effectivenessresultaretheprobabilityoferadicationoflow gradedysplasiaaftertreatmentwithRFA,theprobabilityofprogressingtocancerfromlow gradedysplasia,andthecostofRFA.

Inthesensitivityanalysis,ifthefrequencyofsurveillanceisreducedaftereradicationoflow gradeorhighgradedysplasia,theresultingICERis$71,075.

MSACfoundthatforHGD,basedonanestimatedprevalenceof100cases,ifdirect replacementofRFAoccurredforoesophagectomy,theoverallcostsavingswouldbe

$1,259,446. IfRFAwasusedtotreat100patientsinsteadofEMRorAPC,therewouldbea totaladditionalcostof$778,146or$606,155respectively. Thiscostanalysisassumedthat RFA,EMR,APCandoesophagectomyhaveequivalenteffectiveness,withnoaccountfor reductioninqualityoflifewithoesophagectomy.

MSACnotedthattheaverageco-paymentsforoneyearofRFAtreatmentwouldbe$487for bothLGDandHGD. Theyalsonotedthatthepatientwouldbeliableforthedisposable cathetersusedineachRFAprocedurewhichwouldcostthepatient$6,339inthefirstyear.

MSACnotedthatallMBSitemsforRFA,EMRandAPCareperformedintheoutpatient setting. Thereforeanyoutofpocketcostassociatedwiththeseitemswillcontributetowards theExtendedMedicareSafetyNet(EMSN).Thetotaloutofpocketcostsfortheseitemsis belowthe$1,126threshold($562.90forconcessioncardholders). Consequently,outof pocketcontributionproceduresrelatingtoBOareunlikelytoimpactupontheEMSN.

MSACnotedthattheICERofRFAforLGDwassensitivetotheprobabilityoferadicationof LGDaftertreatmentwithRFA,therateofprogressionfromLGDtoHGDand/orcancer,and thecostofRFA. MSACnotedthattheICERwaslikelytoremainveryhighbutuncertainin anysensitivityanalysesinvolvingtheseparameters.

WhenreviewingtheeconomicimplicationsofRFAforHGD,MSACnotedthatiftherateof RFAtreatmentfailureleadingtooesophagectomyweretobeconsidered,theremaybea reductionintherelativecost-effectivenessofRFAforHGD. Conversely,MSACalsonoted theassessmentreportdidnotattempttoquantifythecostofmortalityassociatedwith oesophagectomy,whichislikelytopositivelyaffecttherelativecost-effectivenessofRFA.

10.Financial/budgetaryimpacts

MSACnotedestimatesthatapproximately100patientsperyeararediagnosedwithhigh gradedysplasia(HGD)inAustralia,withanaverageageatdiagnosisof60.Approximately

300patientsperyeararediagnosedwithLGD.

MSACnotedthatbasedonanestimatedincidenceof299casesofBOwithLGDperyear, RFAforLGDwouldincuracostof$489,433perannumtotheMBS. Basedonanestimated incidenceof100casesofBOwithHGDperyear,RFAforHGDwouldcosttheMBS

$163,690perannum.

11.Othersignificantfactors

ForBOwithHGD,MSACnotedthatoesophagectomyisahighlymorbidprocedure comparedwithRFAandthatRFAiscostsavingcomparedwithoesophagectomy. However, MSACwasnotabletodeterminethenumberofpatientswhowouldfailRFAandultimately berecommendedtohaveoesophagectomy.

MSACnotedthatRFAismorecostlythanAPCandEMRbutthattherewasnocomparative clinicaleffectivenessdatafortheseprocedures. ItnotedthataCochranereviewconcluded thatRFAappearedtobethemostsuccessfultherapytodateforpatientswithHGDinBO aftercomparingthedifferentinterventions(exceptoesophagectomy). MSACalsonotedthat theRFAcathetersarenotabletobeincludedontheProsthesisList,andthusmaybeacost thatwouldbebornebythepatient.

MSACsuggestedthatrelevantprofessionalgroupsshoulddevelopsomeformof accreditationforthisprocedure.

12.SummaryofconsiderationandrationaleforMSAC’sadvice

MSACreconsideredthestrengthoftheevidencerelatingtothesafety,effectivenessandcost- effectivenessofradiofrequencyablation(RFA)forthetreatmentofBarrett’sOesophagus

witheitherlowgradedysplasia(LGD)orhighgradedysplasia(HGD).MSACnotedthat therearelimiteddataavailableregardingtheprevalenceofBarrett’sOesophagusin Australia. However,therehasbeenanincreaseinthefrequencyofdiagnosisofBarrett’s Oesophagusfrom2.9to18.9per1000endoscopiesbetween1992and2002,althoughthese datadonotspecifytheseverityofdiseaseorlevelofdysplasia. MSACnotedestimatesthat approximately100patientsperyeararediagnosedwithhighgradedysplasia(HGD)in Australia,withanaverageageatdiagnosisof60.Approximately300patientsperyearare diagnosedwithLGD.ThenaturalhistoryofBOispoorlyunderstoodhoweverHGDis generallyacceptedasaprecursortooesophagealcancer.Theskillsofexpertpathologistsare

neededtodifferentiatebetweenlowgradedysplasia(LGD)andhighgradedysplasia(HGD).

MSACseparatelyconsideredthestrengthoftheevidenceinrelationtoradiofrequency ablation(RFA)inthetreatmentofBarrett’sOesophaguswitheitherLGDorHGD. RFAis generallyprovidedasadayprocedureperformedunderconscioussedationinanoutpatient settingbyagastroenterologistorsurgeontrainedintheprocedure.

ForLGD,RFAwascomparedwithcurrentconservativetherapy(acidsuppressionand surveillance)andAPC.ForHGD,RFAwascomparedwithoesophagectomyoralternative endoscopictherapies(includingEndoscopicMucosalResection(EMR)andArgonPlasma Coagulation(APC)). MSACfoundthattheevidencebaseforthisassessmentwasverypoor, withonerandomisedcontrolledtrial(RCT)applicabletotheAustraliansetting,andthe

lengthoffollowupintheincludedstudiesinsufficienttodeterminethelongtermsuccessrate

ofRFA.

MSACagreedthatthelimitedevidencesuggeststhatRFAissafeforthetreatmentof Barrett’sOesophaguswithdysplasiaand/orearlyintra-mucosalcancer(IMC). However, lack ofcomparativedatapreventedthesafetyofRFAbeingdirectlycomparedtoother treatmentsavailableforpatientswithLGD,HGDandIMC. Asaresult,conclusionscannot bedrawnastowhetherRFAissaferthansurveillanceorAPCinpatientswithLGD. In addition,limitationsintheliteraturealsopreventedthecomparisonofthesafetyofRFAto APC,EMRoroesophagectomyforpatientswithHGDandIMC. HoweverMSACaccepted thatRFAhadalowermorbidityandmortalitythanoesophagectomyandthuswouldbemore desirablethananoesophagectomy

ThelimitedliteraturesuggestsRFAiseffectiveforachievinghistologicaleradicationof intestinalmetaplasia(IM)anddysplasiaatamucosallevel. Lackofcomparativedata preventedtheclinicaleffectivenessofRFAbeingdirectlycomparedtootheravailable treatments.

WhenreviewingtheeconomicimplicationsofRFAforLGD,MSACtooknoteofthelow progressionratefromLGDtoHGDand/orcancer.ForLGD,replacingsurveillancewith RFAwouldyieldanadditionalcostof$10,175perpatient,givinganincrementalcost- effectivenessratio(ICER)forRFAcomparedtosurveillanceof$78,975perqualityadjusted

lifeyear(QALY)gained. MSACconcludedthatthisICERwassensitivetotheprobabilityof eradicationofLGDaftertreatmentwithRFA,therateofprogressionfromLGDtoHGD and/orcancer,andthecostofRFA.MSACnotedthattheICERwaslikelytoremainvery

highbutuncertaininanysensitivityanalysesinvolvingtheseparameters.

WhenreviewingtheeconomicimplicationsofRFAforHGDMSACnotedthatiftherateof RFAtreatmentfailureleadingtooesophagectomyweretobeconsidered,theremaybea reductionintherelativecost-effectivenessofRFAforHGD. Conversely,MSACalsonoted theassessmentreportdidnotattempttoquantifythecostofmortalityassociatedwith oesophagectomy,whichislikelytopositivelyaffecttherelativecost-effectivenessofRFA. Takingtheseuncertaintiesintoaccount,MSACconcludedthatRFAforHGDwaslikelyto haveacostadvantageoveroesophagectomy.

MSACwasunabletodeterminethecost-effectivenessofRFAforHGDduetolimitationsof thedata. CostingshowedthatRFAislikelytobelessexpensivethanoesophagectomy,but moreexpensivethanAPCandEMR. Furthermore,duetothecostofthedisposable catheters,theremaybeaccessandequityissuesforuninsuredpatientswithlow socioeconomicstatus,whothereforemaybemorelikelytochooseotherformsoftreatment

ofHGDduetothelowercosttothepatient. However,theassessmentreportdidnotethatthe methodoftreatmentforHGDcanvarydependingonclinicalpresentationandtreatment methodsarenotalwaysinterchangeable.

MSACnotedthatoesophagectomyisaninvasiveprocedurewithmorbidityofapproximately

30-50%andmortalityof2%inAustraliancentres. MSACalsonotedthatoesophagectomyis currentlyfundedthroughtheMBS,butEMRandAPCforBarrett’sOesophagusarenot reimbursed.

MSACalsoagreedthattheaccuratediagnosisofdysplasticBarrett’sOesophagusisan importantandcomplexstepinthetreatmentalgorithm,andnotedexpertadvicethattwo experiencedpathologistsshouldconferonthefinalgrading. Thechoiceoftreatmentshould beoverseenbyamulti-disciplinaryteamand,ifconsideredappropriateforthepatient,RFA shouldbeperformedbyanappropriatelytrainedspecialistgastroenterologistorsurgeon. MSACagreedthatboththeclinicaleffectivenessandeconomicbenefitofRFAdependupon theaccuracyofthediagnosisofHGD,andnotedthatprofessionalbodiesshouldbeinvolved indevelopingstandardsforboththediagnosticprocessaswellasfortheconductofthe procedure.

MSACagreedthat,atleastintheshortterm, RFAissafeandeffectiveforLGD,butitisnot cost-effective. MSACfurthernotedthatLGDmayregressfollowingconservativetreatment forgastro-oesophagealrefluxdisease(GORD),anddoesnotnecessarilyprogresstoHGDor cancer. MSACthereforedidnotsupportpublicfundingforRFAforBarrett’sOesophaguswithLGD.

ForHGD,MSACtookintoaccountthattheonlyothercomparativeprocedurereimbursedon theMBS,oesophagectomy,isaninvasiveprocedurewithsignificantmorbidityandmortality ratescomparedtoRFA. AsRFAforHGDappearstobesafeandclinicallyeffective,and costsavingcomparedwithoesophagectomy,MSACsupportspublicfundingforRFAfor Barrett’sOesophaguswithHGD.

13.MSAC’sadvicetotheMinister

Onthebasisofitshighcostanduncertaintyofclinicalbenefitduetouncertaintyof progressionratefromBarrett’sOesophaguswithlowgradedysplasia(LGD)tooesophagealcancer,MSACdoesnotsupportpublicfundingforradiofrequencyablation(RFA)inthe treatmentofBarrett’sOesophaguswithLGD.

Basedonabettersafetyprofileandlowercostthanoesophagectomy,butnotinglackof evidenceofcomparativeclinicaleffectiveness,MSACsupportspublicfundingforRFAfor Barrett’sOesophaguswithhighgradedysplasia(HGD). MSACadvisesthatthediagnosisof HGDshouldbeconfirmedbytwoexpertpathologistswithexperienceinupper gastrointestinal pathology,thattreatmentoptionsforpatientswithHGDshouldbereviewed byanappropriatemulti-disciplinaryteam,andthatRFAshouldbeperformed(where indicated)byanappropriatelyqualifiedspecialistgastroenterologistorsurgeonwhohas receivedspecifictrainingintheprocedure.

14.ContextforDecision

ThisadvicewasmadeundertheMSACTermsofReference. “MSACisto:

AdvisetheMinisterforHealthandAgeingonmedicalservicesincludingthosethatinvolve neworemergingtechnologiesandproceduresand,whererelevant,amendmenttoexisting MBSitems,inrelationto:

•thestrengthofevidenceinrelationtothecomparativesafety,effectiveness, cost-effectivenessandtotalcostofthemedicalservice;

•whetherpublicfundingshouldbesupportedforthemedicalserviceand,ifso,the circumstancesunderwhichpublicfundingshouldbesupported;

•theproposedMedicareBenefitsSchedule(MBS)itemdescriptorandfeefortheservice wherefundingthroughtheMBSissupported;

•thecircumstances,wherethereisuncertaintyinrelationtotheclinicalor

cost-effectivenessofaservice,underwhichinterimpublicfundingofaserviceshouldbe supportedforaspecifiedperiod,duringwhichdefineddatacollectionsunderagreed clinicalprotocolswouldbecollectedtoinformare-assessmentoftheservicebyMSAC attheconclusionofthatperiod;

•othermattersrelatedtothepublicfundingofhealthservicesreferredbytheMinister. AdvisetheAustralianHealthMinister’sAdvisoryCouncil(AHMAC)onhealthtechnology

assessmentsreferredunderAHMACarrangements.

MSACmayalsoestablishsub-committeestoassistMSACtoeffectivelyundertakeitsrole. MSACmaydelegatesomeofitsfunctionstosuchsub-committees.”

15.LinkagestoOtherDocuments

MSAC’sprocessesaredetailedontheMSACWebsiteat: