Gazette 2, March 2018
Welcome to the March 2019 Glaukos Gazette
WORD FROM THE GM
Dear Glaukos Customers,
Procedural and device innovations occur in many surgical specialties, such as in cardiac surgery and surgical oncology, which have fostered the movement from open, invasive to minimally invasive surgeries for less aggressive stages of diseases. For the patient, it offers potential for faster recovery and less risk of intra- and postoperative complications. For the healthcare system, it enables efficiencies and resource savings. In ophthalmology, micro-invasive glaucoma surgery (MIGS) has emerged as a new alternative for patients with mild to moderate open-angle glaucoma (OAG).
iStent® platform technologies have amassed over 100 journal publications reviewing or demonstrating safety, efficacy, effectiveness and cost savings. Over 500,000 patients in 38 countries have benefited from Glaukos® trabecular micro-bypass therapies that advance the existing glaucoma standard of care.
The intended purpose of iStent inject® based on the Therapeutic Goods Administration’s certificate (ARTG Identifier 250914) is:
“The iStent inject Trabecular Micro-Bypass System is intended to reduce intraocular pressure in adult patients diagnosed with mild to moderate primary open-angle glaucoma (POAG) currently treated with ocular hypotensive medication. The device can be implanted with or without cataract surgery.”
Over the past two years Glaukos has worked through the MSAC process to ensure access for all patients, regardless of other diseases such as cataract outside of their control. Starting November 1, 2018, the Medicare Benefits Schedule increased reimbursement of trans-trabecular devices for patients with OAG who are undergoing cataract surgery who are not adequately responsive to or who are intolerant of anti-glaucoma medications. (MBS item 42705.)
It is disappointing that despite the significant efforts by ASO, ANZGS, RANZCO and with the support of Glaukos that the MSAC resubmission to secure funding for patients in a stand-alone procedure was rejected by MSAC. MSAC did not support listing of TB-MIGS as a standalone procedure due to their perception that there is insufficient evidence and what they believe is an undefined population.
Glaukos will continue to support efforts to secure funding for this group of patients who are in need of access to these procedures. The commitment to transform glaucoma therapy is at the core of Glaukos. I thank each of you for your support and look forward to continuing this journey together.
Kind regards,
GLENN FAWCETT
General Manager
GLAUKOS SYMPOSIUM
Attended by over 100
During RANZCO’s 50th Annual Scientific Congress, Glaukos Australia held a symposium which was attended by over 100 delegates. The symposium titled “REDEFINING MIGS” was held on Sunday 18 November, 2019, at the Playford Hotel in Adelaide.
The event was moderated by Dr Paul McCartney (TAS) and the faculty included: Dr Colin Clement (NSW)); Dr Ridia Lim (NSW); Dr Frank Howes (QLD); Dr Mitchell Lawlor (NSW) and international guest, Dr Paul Harasymowycz (CAN).
Dr Frank Howes defined MIGS as having the following characteristics:
- Ab interno approach
- Conjunctival sparing
- Minimally traumatic
- Micro incision
- Efficacious
- Extremely high safety profile
The faculty discussed their experiences with MIGS devices, such as the iStent inject®, other glaucoma surgery devices and interventions and where each modality fits in the treatment algorithm.
Dr Paul McCartney
Dr Frank Howes
Dr Colin Clement
Dr Mitchell Lawlor
Dr Paul Harasymowycz
Dr Ridia Lim
In the recent U.S iStent inject pivotal trial, iStent inject statistically significantly reduced unmedicated diurnal IOP and reduced medication burden in patients undergoing cataract surgery.
Experience from Australia presented showed similar observations in the interim pooled data from Clement et. al. from analysis of 4 surgeon’s practices: 66% were medication free versus 18% pre-op and a 65% reduction in mean IOP was observed at 12 months1.
Speakers agreed that trabecular microbypass procedures such as the iStent inject met the definition of MIGS. Furthermore, for those starting out, they highlighted the key benefits are:
- Studies suggest that the procedure is safe and effective
- Designed to restore the eyes natural outflow pathway
- At the discretion of healthcare professionals may reduce or eliminate the patient’s medication burden
- Clement C. Outcomes with 2nd generation trabecular micro-bypass stents in patients with glaucoma: multi-center, multi-surgeon experience. APGC 2018 Presentation.