MBS rejects non-invasive treatment for essential tremor.

Medicare funding has been refused for a non-invasive ultrasound alternative to deep brain stimulation (DBS) to control the symptoms of refractory essential tremor.

The Medicare Services Advisory Committee (MSAC) has rejected an application for a MBS listing for magnetic resonance-guided focused ultrasound (MRgFUS) for medically refractory essential tremor submitted by sponsor Insightec.

MSAC accepted that there will be patients who would prefer to use MRgFUS rather than the more invasive procedure of DBS to manage refractory essential tremor.

“However, MSAC noted that the level of evidence is very poor for MRgFUS, which means that MSAC was unable to ensure that MRgFUS is at least as safe, clinically effective and cost effective as DBS,” it said

MSAC also noted issues with the procedural requirements, fee structure and frequency of imaging, and that the role of ipsilateral retreatment and contralateral (non-dominant) treatment was not supported by the current evidence base.

IIH on the rise in women: Australian study

The incidence of idiopathic intracranial hypertension appears to be increasing, according to a ‘snapshot’ based on records of neurologists in Tasmania.

A retrospective study led by Dr Natasha Krishnadas of the Department of Neurology, Royal Hobart Hospital, found the incidence of IIH to be 5.4/100 000 for patients that fulfilled MDC. All the patients were females, aged between 18 and 45 years, and headache was the most commonly reported symptom, with high rates of pre-existing or concurrent migraine diagnoses.

The incidence of IIH was markedly higher than reported in international studies within the last decade but comparable to rates seen in other studies for females of childbearing age, the study authors said.

The findings are published in BMJ Neurology Open.

Hospital doctors bullied to discharge patients early

More than 60% of hospital doctors feel coerced to discharge patients before they are medically ready, according to a survey conducted by the SA Salaried Medical Officers Association.

Almost 40% of doctors said the pressure to discharge patients came from hospital executives and half said the early discharges negatively impacted on care, according to report In Daily.

The survey supports a “Time to Care” campaign by SASMOA which says that medical care is being compromised by lack of staff numbers to meet demand and lack of time to provide appropriate medical care for patients.

“Medical decisions should be made by doctors based on a medical assessment of patient need and not based on cutting costs,” the Association said.