Calls to fund faecal calprotectin test

Thursday, 17 Mar 2016

Gastroenterologists have been urged to increase pressure on the Federal Government to fund the simple and relatively inexpensive faecal calprotectin test under the MBS.

The FC test is already widely used overseas to discriminate between IBD and IBS, reducing the rate of colonoscopies, but its absence from the MBS seems to have limited uptake in Australia.

An application for a Medicare item number for the test was lodged with the Medicare Services Advisory Committee in 2014 but a decision is yet to be made.

According to an article in the Internal Medicine Journal, Australian gastroenterologists endorse the use of FC to discriminate between IBD and IBS, to check for mucosal healing in IBD and to reduce colonoscopy rates.

“Absence of MBS funding is an important factor contributing to the lack of usage of FC, in addition to lack of familiarity with FC testing and availability,” the authors wrote.

Co-author Dr Omar Elnawsra, a gastroenterologist at Liverpool Hospital, said the test could help patients avoid unnecessary colonoscopies and the risks associated with the invasive procedure, and would also save significant health costs.

According to the article the cost of FC testing is less than $100, while the cost of one colonoscopy with biopsies in an adult patient aged 18 years or over was estimated at $2151.74.

“From a health economy perspective it ticks all the boxes and from a patient perspective when it comes to complications it does too,” Dr Elnawsra told the limbic.

“Colonoscopy is definitely much safer than it used to be but it’s still invasive and that carries risks.”

The article surveyed 140 gastroenterologists, and found 73 per cent had used the test, although this fell to 64 per cent when they were asked if they had used it within the last two years.

The gastroenterologists were almost unanimous in their view that the FC test was a reliable method for differentiating between IBD and IBS, while the majority of users (79 per cent) and non-users (68 per cent) reported they would “use FC to defer or avoid colonoscopies if the test were MBS-funded”.

Dr Elnawsra said the test should be fast-tracked to the MBS, especially given the fact that Australia is now number one in the world for IBD.

“We’re way behind in Australia from this point,” he said. “It’s a good, reliable and cheaper alternative to colonoscopy and if you can make early diagnosis in IBD it makes a huge difference to the outcomes.

“Gastroenterologists are really keen for this to happen, they know it will make a difference.”

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