Newsletter

By Marc A. Russo, President, International Neuromodulation Society, MBBS DA (UK) FANZCA FFPMANZCA

I am writing to you today because both myself and the International Neuromodulation Society (INS) Executive Officers have been flooded with calls from members who, like us, are concerned about the methodological flaws in a recent study on SCS published in the prestigious journal JAMA (Journal of American Medical Association) and the likelihood for a range of patients, doctors and healthcare delivery systems to reach erroneous conclusions on the evidence base for spinal cord stimulation (SCS) based on this one study.1
The flaws are so manifold and the statements of the authors so disparaging of the whole field that I feel it is important that all members of the INS have the facts available to them to help dispel this misinformation. In particular I would urge each and everyone of you to use your social media and networking channels to educate those around you as to the true nature of how this study was conducted as I’ve enumerated in the points below. Together in a concerted effort we can ensure that this vital information is delivered where it is needed before payers use this flawed study as justification to cease covering SCS.
A formal letter to the Editor of JAMA will be forthcoming from signatories of multiple medical societies including the INS but INDIVIDUAL activity will have more effect in the court of public opinion. Patient access to neuromodulation, including pain relief, must be a first and last priority of both practitioners and the societies that represent them.

The Neuromodulation Society of Australia and New Zealand (NSANZ). NSANZ is a not-for-profit medical society aimed at;

– Raising awareness of neuromodulation,

– Promoting knowledge and understanding of neuromodulation

– Promoting the safe and professional practice of neuromodulation

– Promoting, assisting and encouraging research into the field of neuromodulation

Implantable devices are used for defined medical conditions include pain, functional neurological pelvic disorders like incontinence and movement disorders like Parkinson’s disease. These therapies have been defined and studied and when used appropriately for the correct indication can be lifesaving.

Important points to be made for this submission

1) It is disappointing that this consultation paper seeks to present the current arrangements regarding prostheses benefit setting in such a negative way, particularly given the role that the prosthesis listing has to ensure access for patients and clinicians choice when it comes to access medical technology in the private sector.

2) We understand the need to reduce cost pressures on the private health insurers, but this must not be at the expense of patients not receiving a defined therapy that is indicated and that they require. We will provide an argument as such below.

3) We request a representative of our society be included in the discussions moving forward on this consultative process with the aim of providing this cost-effective therapy for those that need it most and to avoid unnecessary patient suffering and an ongoing burden to the community.

Following the article ‘To hell and back: Devices meant to ease pain are causing trauma’ by Liam Mannix, in The Age and SMH newspapers, NSANZ lodged a complaint with the editor of these papers, stating:

‘From a medical perspective, the recent article “To hell and back” is concerning in terms of the inaccuracies and the lack of disclosure by the journalist [1]. We believe this is not a balanced piece of journalism, which the public has come to expect from a reputable newspaper such as yours (The Age and SMH).’

On 28 February 2022 NSANZ sent a letter to the federal Health Minister, The Hon Greg Hunt, stating concerns following the changes with MBS and calling for further changes to be made.

NSANZ are calling for the following to be done immediately:
– The role out of these changes to be halted.
– The inconsistencies require careful and urgent re-consideration and correction.
– The many unanswered questions need clear answers and explanations.
– The MBS Task Force Committee will need to be re-convened to understand why their recommendations were not implemented.
– Corrections, explanations need to be made.
– Answers to our questions need to be addressed.

Dear Friends and Colleagues,

As we enter the final quarter of the 2021, I find myself reflecting on 2021 and what 2022, will look like.

Social restrictions may be lifting imminently, which is a relief for the our communities, but hospital restrictions will continue for the foreseeable future, notably here in Victoria, so we are again, entering uncharted territory. Restrictions include a 50% restriction on theatre time as well as restrictions to Category 1 and Category 2-urgent cases. What this means on the ground for our patients, only time will tell.

A total of 209 delegates registered for the virtual NSANZ 2021, including delegates, presenters and sponsor representatives.

The program included 3 plenary sessions, 8 concurrent sessions, 6 sponsored sessions, 6 Meet the Experts sponsored sessions and 17 3-minute e-poster recordings.

The Neuromodulation Society of Australia and New Zealand supports the Australian Government’s decision to temporarily suspend elective surgery, except for; Category 1 and urgent Category 2 procedures.

The Prime Minister has left the categorisation of the proposed surgery (Category 1 or urgent Category 2) to the treating physicians/surgeons.

It is vital that we as physicians/surgeons, both morally and ethically, do what is correct for our patients, their families and our communities, both local and global.

We must do what is right.