Australian Psychiatrists push for rTMS to be subsidised

Internationally recognised as an effective therapy for Depression, Psychiatrists want to see rTMS subsidised in the public health system

Members of the Royal Australian and New Zealand College of Psychiatry are putting forward a new submission to have rTMS listed under Australia’s public health fund, Medicare.

According to the report on ABC radio, there are many internationally recognised studies which support the evidence of rTMS as an effective therapy in so-called ‘Treatment Resistant Depression’, with a number of countries such as The Netherlands, already subsidising the therapy in the public healthcare system.  In the United States all private health insurers reimburse for rTMS therapy.

rTMS (which stands for ‘repetitive Transcranial Magnetic Stimulation’) is a non-invasive treatment where a pulsating magnetic field is positioned on the head to externally stimulate specific areas of the brain. This improves the communication between regions of the brain involved in Depression and other mental illnesses.

Talking to AM radio (ABC) a spokeswoman from the federal health department indicated that a new mental health committee will be set up in Australia next year with the department welcoming new applications for funding, if there’s new evidence for the comparative effectiveness of rTMS.

Professor Paul Fitzgerald, neuromstimulation expert and fellow of the college of Psychiatry, addresses an immediate problem with this criteria of assessment given that it is difficult to make compare rTMS as a therapy, against medications, which are pharmacological.

“We have to try to convince Medicare that the standards by which evidence is being judged pretty much everywhere else in the world, are also reasonable to be applied locally” says Prof. Fitzgerald in the radio segment.

Neither public nor private health insurance in Australia lists rTMS as a subsidised therapy, but public interest in the therapy has increased as its application and efficacy becomes more well-known.

neuroCare which has opened its doors in Sydney and Melbourne, is one of the first private practices in Australia to offer rTMS in an outpatient setting.

“We tend to see patients who have been suffering Depression for a number of years, and where medications haven’t worked out for them or they have negative side-effects” says Dr. Mark Ryan, Consultant Psychiatrist at neuroCare Sydney

“It may be that the medication offered limited efficacy at the outset, or the patient just didn’t agree with the problematic side-effects if the outlook would have been to rely on medication indefinitely.”

Although certain related medications and professional services are subsidised in Australia, Dr. Ryan points out that relying on these services long-term is also expensive.

“There is a personal, social but also economic burden of such an illness”

People who do not respond to or who wish to avoid medications to treat Depression, may find an effective alternative in rTMS.

“Using a detailed intake procedure like we do at neuroCare, and by combining personalised rTMS with psychotherapy, we see results that are quick and long-lasting”

says Dr. Ryan, who is using the technique at the clinic in Sydney.

A therapy program of rTMS can be completed in as little as 7 weeks, with patients attending sessions at least twice per week. Antidepressant effects are often noticed after 10 – 15 sessions, 20 – 30 sessions usually lead to longer lasting results.

“With this therapy we are on the cusp of a paradigm shift in treating Depression and other mental health disorder, actually addressing the underlying causes of the illness rather than symptom management. rTMS needs to be adequately funded so that this therapy is more easily accessed by the people who need it” says Dr. Ryan.

To find out more about the evidence of rTMS as a treatment for depression, you can find a list of scientific publications here

To find out more about personalised therapy for Depression in Australia, visit www.neurocareclinics.com.au

Source: “Psychiatrists push for depression treatment rTMS to be subsidised” by George Roberts on AM, ABC Radio, Saturday 21 Oct 2017

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