The Medicare Benefits Schedule (MBS) will shake up the back pain industry, by no longer supporting spinal fusion for uncomplicated axial chronic lower back pain.
The changes are in line with a best-practice evidence-based approach and are consistent with NPS Choosing Wisely Australia’s recommendations.
Historically, lumbar spinal fusion was used for the treatment of demonstrated spinal instability following trauma or cancer.
Its more recent use as a treatment for uncomplicated axial chronic lower back pain is not supported by scientific data. There is no evidence the surgery will lead to better outcomes compared with non-surgical treatments, but there are greater risks to the patient and a significant financial burden.
The MBS Review Taskforce also placed new restrictions on requesting knee MRIs to ensure tests are only given to patients who really need them. While patients who are in pain often demand more scans and tests, in many cases they do not give an accurate indication of a cause of pain and they can lead to more invasive testing and misguided treatments.
The MBS Review Taskforce is working on changes that will improve patient care, modernise the MBS and improve its focus on clinical best practice, and provide greater value for money for patients, providers and the health system.
Painaustralia CEO Carol Bennett said the announcement is important as it will help ensure patients are getting the best possible care.
“The MBS announcement means that for people with uncomplicated axial chronic lower back pain, there is no longer a risk that they will be offered ineffective, expensive and outdated surgery.
“Chronic pain in many cases does not have a defined cause or cure, and the most effective evidence-based approach is multidisciplinary care.”
The changes will be introduced from 1 November 2018.