cervical ADR in Australia

rob_zzz · #1 (**permalink**) 03-07-2007, 12:01 PM

As some may know, cervical ADR used to be available in Australia but it seems that since some time late last year it is no longer offered. I'm not quite sure if the reason is that it is not 'allowed' (i.e. not a legal procedure) or if it is because it is not covered by health insurance.

I've done a bit more hunting around on this and found the following:

This is an excerpt from an explanatory statement issued by minister for health, private health insurance branch, in Aug 06:

artificial intervertebral discs have also been removed from the Prostheses List following the Minister for Health and Ageing’s endorsement of a recent Medical Services Advisory Committee’s recommendation that states “In the absence of evidence of effectiveness, MSAC recommends that public funding for AIDR in the cervical spine should not be supported.” Cervical intervertebral discs removed from the Prostheses List include:
· MC541, Medtronic Australasia, Brian Cervical Disc System;
· MC588, Medtronic Australasia, Prestige Artificial Cervical Disc; and
· SY330, Synthes Australia Pty Ltd, Prodisc L Artificial Cervical Disc.

I think I also found the full medical services advisory committee article on the topic:

http://www.msac.gov.au/internet/msac...t%20(AIDR).pdf

My interpretation of the above (could be completely wrong) - there isn't clear evidence in current studies/literature to show that cervical ADR is more effective, and the cost of it is considerably higher than cervical fusion, and that seems to be the main reason its not been funded. I can't see any horror stories about ADR - seems that it could be about cost, and as the cost is considerably higher but no clear evidence of a significant advantage the decision was made not to fund it. There is nothing in there that seems to imply there are problems as such with cervical ADR when compared to fusion.

I believe it *may* be as simple as that.

If anyone knows more (i.e. is it not allowed or is it just not funded?) I'd be curious to know. As far as I can tell it seems that its about funding (i.e. you theoretically could still have it done if the surgeon agreed and you were willing to pay the full cost) but I'm not sure.

Rob

Hucky :) · #2 (**permalink**) 03-07-2007, 10:25 PM

Rob,

I don't mean this to come across as rude, but why don't you just ring up one of the specialists and ask them?

My understand, when speaking to a rep from Mobi-C is that it was cost too. I am also under the impression that when Cervical ADR takes place, it is a much simpler procedure and the down time from life is a lot quicker than lumbar ADR. I think it's just a matter of time before it will be approved.

If YOU are willing to pay for it, then I think you will get it. If you are willing to pay for it, why don't you go the extra $2-3,000 and go to Germany and have the best operate on you. This is what I would be doing, if I go ahead at a later date. I wouldn't be covered by my health insurance because I was given a compensation payout from the MVA. So, I figure if I have to fork out $30,000 what's another couple of thousand for airfares and accomodation.
Their hygiene is second to none and they have the most experinced surgeons in the world.

Just my 2 cents worth.

Hucky

rob_zzz · #3 (**permalink**) 03-07-2007, 11:12 PM

Hucky - whenever I try to ring to ask any question of a specialist about anything I get knocked back by their receptionists who say I have to make an appointment to speak to them ... maybe I'm doing it wrong.

I was told its politics and also told that they aren't allowed to do them by one of the nurses but I'm thinking that might be incorrect - they can do them if you pay. But it does look like its just politics.

And yes I agree about what you're saying re going overseas if the cost is basically going to be the same.

Hucky :) · #4 (**permalink**) 03-08-2007, 02:34 AM

Rob,

I know you've been to see some NS - so, just ask the receptionist (dragon lady

) to pass on the message to ring you back. When she asks what it is about, just say you have some more questions that you forgot to ask last time you were there. If you've already seen them, and you are now one of their patients, then they are obliged to ring you back.

Dr K. did for me, when I asked a question for someone over in the US. His receptionist is a real dragon !! (must be a pre-requisite for the job

)

Hucky

sahuaro · #5 (**permalink**) 03-08-2007, 03:46 AM

Thank you so much for finding and posting this. I read some and skimmed the rest of the report and would agree with your analysis that there is no gross reason for denial of cervical ADR--for example, horrible adverse events. In fact, the data presented actually show more frequent and more serious adverse events for cervical fusion. So, in terms of thinking about cervical ADR in general, this is reassuring.
In terms of the conclusions of the report, there is much one could take issue with and a few things that are even laughable, but that is besides the point. As has been pointed out, demonstration that ADR preserves adjacent segments will mark a turning point in coverage for the surgery; however, in the data presented for lumbar ADR, there were a few instances of adjacent level deterioration...interesting.

mmglobal · #6 (**permalink**) 03-08-2007, 02:07 PM

I have first-hand information regarding the status of cervical ADR in Oz.

Cervical ADR is NOT banned in Australia. They are dealing with the same kind of reimbursement issues there that we have in the US. Cervical ADR procedures are currently being done in Australia. However, these procedures are being done without Medicare or Health Fund funding.

Mark