Authors' recommendations: MSAC advised the Minister that it supports the extension of the current item descriptor for the interferon gamma release assay (IGRA) to include additional subgroups of patients. The final item descriptor should be finalised by the Department in consultation with relevant groups such as the National Tuberculosis Advisory Committee (NTAC) and then with the MSAC Executive. MSAC advised the Minister that the options to extend the item descriptor including the following subgroups of patients in descending order of the strength of evidence to support the advice from MSAC for that subgroup: 1. patients about to commence long-term immunosuppressive therapy (e.g. tumour necrosis factor [TNF] inhibitors), because it is clinically sensible to perform this assessment before starting long-term treatment with such therapies, rather than waiting until the patient becomes immunosuppressed 2. patients previously vaccinated with the Bacille Calmette Guérin (BCG) vaccine, because this is known to increase the likelihood of a false positive test result with the tuberculin skin test (TST), or Mantoux test, and so the higher specificity of IGRA in BCG-vaccinated patients especially is important 3. patients considered at low risk of latent tuberculosis bacillus infection (LTBI) with a positive TST result, because the evidence of comparative analytical validity between the two test options indicated a significantly lower test positive rate for IGRA without a significantly increased rate of false negatives, leading to a reduction in unnecessary follow-up and unnecessary treatment 4. patients considered at high risk of LTBI with a negative TST result, because the evidence available was not analysed in terms of test negative rates and rates of false positives. MSAC also advised the Minister that there was an insufficient basis to support any increase in the MBS fee associated with IGRA testing, noting the high proportion of bulk billing for current IGRA testing.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1144-public

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Medical Services Advisory Committee

Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.

Contact Name: msac.secretariat@health.gov.au

Contact Email: msac.secretariat@health.gov.au

Copyright: Medical Services Advisory Committee (MSAC)