News in brief: Medicare to fund Tecartus CAR T-cell therapy for MCL; Haematologic malignancies increase; Medicare claims watchdog to get new powers on repayments

Thursday, 11 Nov 2021


Medicare funding of CAR T-cell therapy for R/R MCL

Public funding for Tecartus (brexucabtagene autoleucel), a CAR T-cell therapy for mantle cell lymphoma, has been recommended by the Medicare Services Advisory Committee (MSAC).

MSAC has advised the minister for health that it supports public funding of Gilead’s brexu-cel for adult patients with relapsed or refractory mantle cell lymphoma (R/R MCL).

In its decision statement, MSAC noted that there are few treatment options for patients with R/R MCL and it considered that the level of clinical evidence in support of brexu-cel to be acceptable given the rarity of mantle cell lymphoma and the proposal for its use as a later line of therapy.

However it said support for public funding was contingent on a price reduction to achieve an acceptable cost-effectiveness ratio similar to that for axicabtagene ciloleucel, which MSAC recommended for funding to treat certain refractory or relapsed CD19-positive lymphomas in January 2020.

It said funding would be for patients who have failed immunochemotherapy (first line) and Bruton’s tyrosine kinase (BTK) inhibitor therapy (second line), or who have received immunochemotherapy and who are considered unsuitable for BTK inhibitor therapy due to predicted intolerance.

Haematologic malignancies increase noted in Queensland

Haematologic malignancies are increasing in North Queensland, with some hot spots appearing in the Mackay region, an Australian study suggests.

The study reviewed characteristics for 1,581 haematological malignancies diagnosed in the Townsville Hospital Haematology catchment region between 2005 and 2014.

It found yearly cases rose from 134 to 197 over the decade — possibly due to improved diagnostic work-up, wider availability of newer ancillary diagnostic tests and an increasing elderly population, the authors posited.

It also highlighted geographical variations in the age-standardised incidence rates per 100,000, ranging from 0.5 in Cairns (postcode 4879) to 233.5 in Mackay (postcode 4746).

While the cause of this disparity isn’t clear, the authors suggest environmental factors, such as the Mackay area’s prolific agricultural and mining activities, could play a role in disease development.

“High-quality epidemiological data is integral to blood cancer management and remains an unmet need in regional Australia,” the authors wrote in the Internal Medicine Journal.

“Extrapolating such a study to larger regions and nationally will have major implications for improved healthcare, both in healthcare policy and clinical management,” they suggested.


Medicare claims watchdog to get new powers on repayments

The powers of the Professional Services Review, to investigate and punish inappropriate Medicare claims will be strengthened under an amendment that will extend compliance powers to corporate entities.

A bill going through parliament seeks to extend the reach of the PSR scheme from individual medical practitioners, to hold responsible anyone who employs or contracts practitioners including corporate entities who may offer Medicare services.

The amendment will also strengthen the debt recovery powers of the PSR to seek repayment of Medicare claims from corporate entities and boost fines for withholding information or refusing to cooperate with investigators.

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