News in brief: MBS items for HbA1c Point of Care testing; Dapagliflozin PBS listing for HFrEF; Fracture risk reduced by dairy intake: RCT

Tuesday, 26 Oct 2021

MBS items for HbA1c Point of Care testing

New HbA1c Point of Care testing items 73812 and 73826 for GPs and practice nurses will be introduced on 1 November.

According to Medicare the items  – with a fee of $11.80 will cover POCT by or on behalf of a practitioner who works in an accredited  general practice. Currently HbA1c testing items only cover pathology laboratory tests. The Department of Health says the $2.1 million funding for the tests is expected to provide services for 190,000 tests for Australians with previously diagnosed diabetes.

The criteria for the items stipulate that point-of-care tests are performed for the management of established diabetes and may be claimed a maximum of three times per patient in a 12-month period.

Dapagliflozin PBS listing recommendation for HFrEF

Dapagliflozin’s (Forxiga) PBS listing could soon extend to heart failure with reduced ejection fraction (HFrEF) following the PBAC’s recent recommendation.

It comes after additional information from AstraZeneca proved estimated impacts of listing dapagliflozin for HFrEF on top of type 2 diabetes were “broadly reasonable” and “an appropriate basis for a risk sharing agreement”.

The PBAC agreed the drug added to standard care and, for some patients, “provides a significant improvement in efficacy over standard care alone” when it considered the listing back in July 2021. It also felt the listing would be “cost-effective at the price proposed in the pre-PBAC response” from that time.

Despite recognising dapagliflozin’s efficacy in chronic kidney disease, the PBAC has not recommended the drug’s listing extend further due to “high and uncertain” financial estimates and “significant” overestimations of the eligible population.

Fracture risk reduced by more dairy intake in aged care settings: RCT

Improving calcium and protein intakes with extra dairy foods can reduce the risk of falls and fractures in aged care residents.

An Australian RCT compared fractures, falls and all cause mortality in aged care residents in 30 facilities on a usual meal plan and 30 facilities providing additional milk, yogurt and cheese.

Consumption of dairy foods increased from 2.0 to 3.5 serves per day in the intervention group.

“This nutritional approach using high calcium and high protein dairy foods to increase calcium and protein intakes in institutionalised older adults replete in vitamin D was associated with a 33% reduction in risk of fractures of any type, a 46% reduction in risk of hip fractures, and an 11% reduction in risk of falls relative to controls,” the study said.

There was no observed difference in all cause mortality over the two year study period.

The study said the most likely explanation for the reduction in fractures was fewer falls and slowing progression of bone fragility.

Disclosure: The study, led by the University of Melbourne, was funded in part by Dairy Australia and other industry groups.

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