4.Areas of responsibility of the Pathology Clinical Committee

The review process of the services covered in the report commenced with review by the Endocrinology Clinical Committee of 60 endocrine-related items on the Medicare Benefits Schedule (MBS). The Endocrinology Clinical Committee made recommendations to the Taskforce and relevant committees, based on rapid evidence review and clinical expertise.

Of these 60 items, 43 were related to endocrine pathology tests. The review of these 43 items was performed from a requesting clinician’s perspective and were provided as advice to the Pathology Clinical Committee and its Chemical Working Group

The Chemical Working Group reviewed the Endocrinology Clinical Committee report on the 43 items relating to endocrine pathology tests and made recommendations to the Pathology Clinical Committee. This review was from a chemical pathology perspective with input from a GP who is a permanent member of the group. Subsequently the recommendations were discussed with the Endocrinology Clinical Committee. This report presents the Pathology Clinical Committee recommendations, with reference to the Endocrinology Clinical Committee report that was made available to the Pathology Clinical Committee for review and discussion before making recommendations.

A list of the Endocrinology Clinical Committee recommendations can be found in Appendix A of this report for comparison with the recommendations proposed by the Pathology Clinical Committee.

The 43 endocrine-related pathology test items include thyroid function testing, diabetes-related testing, and other hormone testing. In the 2014/15 financial year these items accounted for about 12.6 million services and $324 million in benefits. Over the past 5 years, service volumes have increased by 6.1 per cent per year, and benefits have increased by 6.3 per cent per year. This growth is largely explained by an increase in the number of services per capita (Figure 1). TSH quantitation, diabetes-related items and TFTs account for most of the total services (Figure 2).

Figure 1. Drivers of growth in utilisation of endocrine-related pathology test items, 2010–15 financial year.

Overall, total benefits increased by 6.3 per cent, reflecting the total increase in the number of services (6.1 per cent). This was mainly attributable to an increase in the number of services per 100,000 patients (4.7 per cent) rather than the number of benefits per service (up 0.3 per cent) or population increase (1.3 per cent).

1 Compound annual growth rate, or the average annual growth rate over a specified time period
SOURCE: MBS data and ABS data –“3101.0 Australian Demographic Statistics Jun 2010 and Jun 2015”

Figure 2. Endocrine-related pathology tests item groups by service volume, 2014–15.

Groups with service volumes > 1000 were, in decreasing order:1. TSH tests (item numbers 66716 and 66722–66734): 41.6 per cent of total services, 4.4 per cent compound annual growth rate (CAGR), $136.7 million in benefits.2. Diabetes-related items (item numbers 66542–8, 66551–4, 66841, 66557 and 66560): 23.2 per cent of total services, 4.6 per cent CAGR, $47.1 million in benefits.3. TFT (item number 66719): 17.4 per cent of total services, 11.1 per cent CAGR, $66.5 million in benefits.4. Quantitation of hormones or binding proteins (item numbers 66695–66707): 10.1 per cent of total services, 7.0 per cent CAGR, $50.5 million in benefits.

Source: MBS data

Source: Department of Health, unpublished data, date of processing, accessed on 10 October 2016