In 2013 our Oncofertility Consumer focus groups meet to discuss oncofertility priorities from a patient perspective and two areas were highlighted consistently across cancer patients and family members:

1. The need for financial assistance or Medicare item numbers to make fertility preservation more affordable
2. Access to more resources covering different aspects of oncofertility care.

Working with a team of experienced clinicians Dr. Antoinette Anazodo, Prof Kate Stern, Prof William Ledger, Prof David Molloy, Prof David Handlesman and Brigitte Gerstl we have submitted a number of Medicare applications which are in different stages of completion:

New Item numbers:

1. Ovarian Repositioning. New Medicare Benefits Schedule (MBS) Items 35730: Ovarian Repositioning was included on the Medicare Benefits Schedule on the 1st May 2017.
2. Protocol to guide the assessment of processing and cryopreservation of male gonadal tissue and gametes prior to gonadotoxic treatment to preserve fertility for the future 1434a. Maximum of two semen collection cycles, one cycle collected prior to a patient undergoing the first cytotoxic/radiation treatment and the second cycle to be collected if the patient has relapsed and requires treatment. A semen cycle collection process involves obtaining up to 3 semen samples on alternate days producing up to 50 cryopreserved straws of frozen sperm (a cycle is considered to be a set of semen samples collected over a few days ahead of a treatment).Accepted by ESC November 2017 MBS Schedule fee of $495. Awaiting Minister Hunt’s sign off and we anticipate that it will be available on the Medicare Benefits Schedule toward the end of 2018.

These Medicare item number are currently under review by the Medicare Services Advisory Committee: Evaluation Sub-Committee (ESC) and we anticipate them being available on the Medicare Benefits Schedule in early 2019

1. Protocol Advisory Subcommittee Report 1435b – Protocol to guide the assessment of processing and cryopreservation of female gonadal tissue and gametes prior to gonadotoxic treatment to preserve fertility for the future. The two Medicare item numbers will include:
   • Proposed new MBS item 1 : Processing and cryopreservation of a partial ovary for fertility preservation treatment for females ≤45 years old, before or after completion of gonadotoxic treatment, at diagnosis or relapse.
   • Proposed new MBS item 2: Processing and cryopreservation of a whole ovary for fertility preservation treatment for females ≤45 years old, before or after completion of gonadotoxic treatment, at diagnosis or relapse.
2. Protocol Advisory Subcommittee Report 1434 – Proposed new MBS item: Anti-Müllerian hormone testing for the assessment of ovarian function, including ovarian reserve for females ≤45 years old, before or after completion of gonadotoxic treatment, at diagnosis or relapse.
   • This application is currently under review by the Medicare Services Advisory Committee and we will be providing updates regarding this application shortly to the website.
3. Protocol Advisory Subcommittee Report 1436 – Protocol to guide the development of Oncofertility Psychological Health Treatment Plan for assessment and support of fertility related psychological distress in cancer patients at diagnosis and following cancer treatment. Review currently ongoing.

Pharmaceutical Benefits Scheme (PBS)
The Medical Oncology Group of Australia and Breast Cancer Network Australia lead by Prof Kelly-Anne Phillips were successful on the 1st December 2017 in a new PBS listing for 6 months of Goserelin (Zoladex) 3.6mg for premenopausal women receiving alkylating therapies for malignancy or autoimmune disorders.

https://www.bcna.org.au/news/2017/12/bcna-welcomes-expanded-listing-of-goserelin-on-pbs/