4.      Areas of responsibility of the Committee

The following 38 MBS items were identified for review, and a complete list of these items can be found in Appendix A.

Δ Phototherapy: Items 14050 and 14053  (2 items)

Δ Treatment of benign and malignant neoplasms: Items 30195–7 (3 items)

Δ Allergy: Items 12003, 12000, 21981 and 53600  (4 items)

Δ Treating malignant lesions by liquid nitrogen cryotherapy using repeat freeze-thaw cycles: Items 30202, 30203 and 30205  (3 items)

Δ Definitive removal of palmar or plantar warts: Items 30185 and 30186 (2 items)

Δ Laser photocoagulation: Items 14100, 14106, 14109, 14112, 14115, 14118 and 14124 (7 items)

Δ Mohs: Items 31000–31002 (3 items)

Δ Telangiectases or starburst vessels: Items 30213 and 30214 (2 items)

Δ Treatment of pre-malignant skin lesions: Item 30192 ( 1 item)

Δ Skin lesions, multiple injections of hydrocortisone or similar preparations: Items 30207 and 30210 (2 items)

Δ Superficial radiotherapy: Item 15000 (1 item)

Δ Administration of immunomodulating agent: Item 14245  (1 item)

Δ Bone or cartilage excision: Item 31340 (1 item)

Δ Laser excision of face or neck tumours: Item 30190  (1 item)

Δ Laser resurfacing for face or neck: Items 45025 and 45026 (2 items)

Δ Vermilionectomy using laser: Item 45669 (1 item)

Δ Treatment of rhinophyma using laser: Item 45652 (1 item)

Δ Full-face chemical peel: Item 45019 (1 item)

At its first meeting, the Committee noted the outcomes from the recently completed skin services review and the announced amendments to the skin patch-testing items (items 12012–21). The Committee agreed that as these changes have the support of stakeholders and are expected to occur on 1 November 2016, the items did not need to be reviewed again. Further information on the skin services review and proposed changes to the skin patch-testing items is available on the MBS Online website.

The 38 items largely consist of a range of treatment items for removing malignant or severely disfiguring lesions or tumours, along with several allergy-testing items. In the 2014/15 financial year (FY), these items accounted for approximately 2,038,664 services and $102,464 million in benefits. Over the past five years, service volumes for these items have grown at 3.8 per cent per year, and the cost of benefits has increased by 5.4 per cent per year.[2] This growth is largely explained by an increase in the number of services per capita (Figure 2).[3] Two items—the ablation of pre-malignant lesions (item 30192) and Phototherapy (PUVA/UVB) for the whole body (item 14050)— account for approximately 62 per cent of total services (Figure 3).[2]

Figure 2: Dermatology, allergy and immunology items drivers of growth

Figure 2 is a graph that shows the increase in percentage for each of the drivers of dermatology, allergy and immunology from 2010 to 2015. The total benefits increased at 5.4%, due to a 3.8% increase on the number of services and 1.5% increase on the average benefits per service. The increase on the number of services was due to a 1.3% increase on the population and the 2.5% increase on services per 100,000.

 

Figure 3: Dermatology, allergy and immunology top ten 10 items by service volume

Figure 3 lists the top 10 dermatology, allergy, and immunology items by service volume for financial year 2014-15. There are 5 columns:  1st column lists the top 10 item numbers starting from the highest total number of services, 2nd column is the item description, 3rd column shows total number of services by thousands, 4th column shows percent of total services for financial year 2014-15, 5th column shows services 5-year compound annual growth rate, and 6th column is the total benefits for financial year 2014-15 in millions. The graph shows that the top two rows for item 30192 Ablation of >10 premalignant skin lesions (33.9% of total services) and 14050 phototherapy of the body (27.7%) are significantly larger than the remaining items. The next two are 30195 9.7% and 30196 8.5%, with the remaining 6 items less than 3.2% each. The 5th column shows annual growth rates from -0.9% to 8.5% with most around 3%. The benefits in column 6 are roughly proportional to the service volumes described above.