The Department reports to MSAC on the utilisation of MBS items. To ensure that new items or item amendments are being used as intended, a predicted vs actual (PvA) utilisation monitoring process has been established for services MSAC has supported and the Department of Health has subsequently listed on the Medicare Benefits Schedule (MBS). This process is not intended to be a review of the clinical information provided during the application process. The PvA utilisation monitoring process assesses the real-world impacts of MSAC-supported applications by comparing projections of claims with actual service volume patterns 24 months after listing.

MSAC can make recommendations in relation to:

• referring inappropriate co-claiming of services to the Department compliance area;
• the MBS item descriptor and fee for the service requiring amendment;
• identifying issues with access to services;
• other matters related to the public funding of health services.

After a service reviewed under the PvA utilisation monitoring process has been considered by MSAC, a Public Summary Document is prepared and made available on the MSAC webpage.

Applications reviewed at the March 2019 MSAC meeting are:

• Application 1182 - The use of Intensity Modulated Radiation Therapy (IMRT)

Applications reviewed at the November 2018 MSAC meeting are:

• Application 1181 - Non-mydriatic retinal photography (NMP) in persons with diabetes

Applications reviewed at the July 2018 MSAC meeting are:

• Application 1145 - Artificial Intervertebral Disc replacement in Patients with Cervical Degenerative Disc Disease
• Application 1166 - Radiofrequency ablation (RFA) for the treatment of varicose veins due to chronic venous insufficiency
• Applications 1362 and 1363 - RAS mutation testing

Applications reviewed at the March 2018 MSAC meeting are:

• Application 1105 - Computed Tomography Coronary Angiogram
• Application 1149 - Holmium Laser Enucleation of the Prostate (HOLEP) Combined with Tissue Morcellation
• Application 1152 - Genetic testing for hereditary mutations in the RET gene
• Application 1180r - Review of items for surgical treatment of obesity

Applications reviewed at the November 2017 MSAC meeting are:

• Application 1150 - Insertion of Colonic Stents
• Application 1153 - Genetic Testing for Hereditary Mutation of the von Hippel-Lindau (VHL) Gene
• Application 1330 - Transcatheter closure of a patent ductus arteriosus

Applications reviewed at the July 2017 MSAC meeting are:

• Application 1272 - Transurethral Injection of Botulinum Toxin (Botox) into the Bladder Wall for Urinary Incontinence due to Idiopathic Overactive Bladder

Applications reviewed at the April 2017 MSAC meeting are:

• Application 1087 - Brain natriuretic peptide assays in the diagnosis and monitoring of heart failure
• Reference 38 & Application 1230 - Testing for HER2 positivity in patients diagnosed with breast cancer to determine eligibility for treatment with trastuzumab

Applications reviewed at the November 2016 MSAC meeting are:

• Application 1161 - Gefitinib first line testing for mutations of epidermal growth factor receptor (EGFR) in patients with metastatic non-small cell lung cancer (NSCLC)
• Application 1168 - Injection of BOTULINUM TOXIN (Botox) for prophylaxis of headaches in adults with chronic migraine
• Application 1173 - EGFR mutation test for treatment of locally advanced (stage IIIB) or metastatic (stage IV) NSCLC for access to erlotinib
• Application 1207 - Diagnostic testing to determine the presence of V600 mutations in patients with locally advanced or metastatic melanoma
• Application 1221 - Transurethral injection of botulinum toxin into the bladder wall for urinary incontinence due to neurogenic detrusor overactivity
• Application 1223 - Insertion, replacement or removal of a cardiac resynchronisation therapy device capable of defibrillation for mild chronic heart failure