[News] Aussie members - the official word on prescriptions and public health support.

[DeepBreathing]

We've seen a number of clinics in Australia requiring prescriptions before supplying machines, especially ASV. I was under the impression that prescriptions are not required, so I wrote to the Commonwealth Department of Health to get this clarified.  I also asked about Medicare (or other) funding of xPAP machines. This is the reply I just received:

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Dear Mr x,

Thank you for your enquiry to the Department of Health regarding whether a prescription is required for an adaptive servo-ventilator (ASV) continuous positive airway pressure (CPAP) machine for complex sleep apnoea.

At present there is no legislative requirement to obtain a prescription to rent or purchase a CPAP machine in Australia from a private medical equipment manufacturer.

It may interest you to know each state and territory allocates funds to offer a range of programs that assist with the cost of health aids, equipment and medical appliances such as CPAP machines. In the case of programs that provide publicly funded CPAP machines, a clinical consultation rather than a prescription may be required to ensure that limited health resources are allocated in the most efficient manner, to those with the greatest clinical need.

At this time, all state and territory programs that provided CPAP equipment have a requirement for a clinical consultation or referral. As I do not have information concerning your current location, information regarding what programs are available has been provided below.

If your family member has not already done so, I recommend they seek clinical advice in relation to the treatment and management of their condition from an appropriately trained practitioner before purchasing a CPAP machine. The Australian Sleep Association (ASA) recommends attending a consultation with a sleep physician as they are best placed to provide the appropriate advice.

Your enquiry did not indicate whether your family member currently holds Private Health Insurance (PHI), but you may be interested to know that private health insurers can contribute to part of the cost of medical devices and equipment under their general treatment policies, also known as extras cover. If they hold cover you may wish to reach out to their service provider to determine whether they offer any assistance with sleep apnoea equipment, as well as any information that may be required to pay the claim.

Sleep Disorders Australia, a voluntary organisation, is a source of information and support to people with sleep disorders. Further information on the services it provides is available on Sleep Disorders Australia’s website at: http://www.sleepoz.org.au/.

Information on State and Territory Programs

• Australian Capital Territory – The ACT Offers a number of services for the provision of CPAP machines depending on the nature of the condition. Further information about the services provided can be found through Access Canberra at: http://www.accesscanberra.act.gov.au by searching Oxygen and Equipment Services.
  
• New South Wales – NSW administers the provision of CPAP machines for qualifying patients through ENABLE NSW. Further information can be found by visiting: http://www.enable.health.nsw.gov.au and searching: Home Respiratory Program.
  
• Northern Territory – The Northern Territory provides CPAP machines through The Top End Health Service (TEHS). Further information about this program can be found by calling TEHS at the Royal Darwin Hospital at: (08) 8922 7610.
  
• Queensland – Queensland provides access to CPAP machines through the Queensland Health Sleep Disorders Program. Further information can be found at: http://www.health.qld.gov.au by searching Sleep Disorders Program.
  
• South Australia – South Australia has no coordinated state-based approach to CPAP provision. However, more information can be found by contacting your general practitioner and asking about what local services are available.
  
• Tasmania – Tasmania provides subsidised CPAP through the Continuous Positive Airways Pressure Program. Further information can be found at: http://www.concessions.tas.gov.au by searching CPAP Equipment.
  
• Western Australia – Western Australia provides government funded CPAP machines through the Sir Charles Gairdner Hospital. Further information can be found by calling the Department of Respiratory Medicine at: (08) 6457 3333
  

We hope the information provided will assist you in finding the appropriate service for your needs.
Kind Regards,
Medical Specialist Services Section
MBS Policy & Specialist Services Branch | Medical Benefits Division
Australian Government Department of Health
T: 02 6289 7315 | E: SurgicalServices@health.gov.au
MDP 8.S.555, GPO Box 9848, Canberra ACT 2601

[Sleeprider]

Nice information. Any thoughts about making it a wiki?

[Gideon]

DB, can you take that into a wiki article. That will prevent it from being lost. Please indicate a date as well.

thanks

[DeepBreathing]

Done http://www.apneaboard.com/wiki/index.php...escription

[StevesSp]

Regarding "Information on State and Territory Programs":

In Queensland, there apparently used to be a program which provided cheap/free machines to sufferers on loan, and access to discounted machines.

This was quietly closed down a couple of years ago, with no mention in the media or announcement by the state government. Maybe it was 'announced' on a tiny poster that was affixed to a wall in the basement of state parliament, for a day or two.

As far as I can tell, the program still exists and still runs, and still has program staff and funding, but all it does now is provide access to 'free' sleep studies. Well, free sleep studies (i.e. 'bulk billed') were available anyway, so in fact that's no help at all.

It seems the program is just another government-funded make work scheme. 

Similarly, Queensland's program that allegedly provides support to people with hearing loss only provides access to hearing tests, which are - once again - free anyhow (unless you choose to attend a clinic that doesn't bulk bill).

Quite a bit of this has happened in Queensland over recent years and the media have somehow missed it all.

[DeepBreathing]

Thanks for the update Steve.

Is that basement behind a door marked "Beware of the leopard"?

We certainly do hear of stuff happening in Qld, but it's usually associated with Bob Katter, Pauline, Barnaby (ex Queenslander), George Christensen and people like that.

[holden4th]

Thanks for posting this - so many OZ CPAP users are unaware of any of these requirements.

I had an interesting online 'chat' with the agent that a certain Aussie CPAP company uses last year. Their online store said that a prescription was required and I asked her to quote the legislation backing this up. Rather than "Let me check this out" she got very gung ho saying I didn't know what I was talking about. I continued to ask her to direct me to the legislation. In the end she ended the conversation.

During the 'chat' I'd provided an e-mail address and the next day got a very strongly worded e-mail from the company about my treatment of their chat agent. This was grist to the mill for me. Needless to say, said expert from the company couldn't direct me to the legislation either after repeated e-mails. Not surprising as it doesn't exist.

The thought that occurred to me afterwards was what would drive a CPAP retailer to ask for a prescription?

So please make this a Wiki and well done Db.

[Snooks]

Good information DeepBreathing and thank you.

I was led to believe that a prescription was required and during my Titration Study at Westmead Hospital last week, they stated that it was essential and that machines could not be purchased without one. It is rather concerning when Medical Staff provide incorrect and untrue information, whether it be on purpose or through ignorance.

Nice to see some fellow Aussies in the forum

[holden4th]

The legal point for these suppliers revolves around machine settings. They can sell you a machine with default settings with no prescription. They can also sell you a machine with settings from the sleep study but this is technically with a prescription. This is where the prescription issue arises. They can't sell you a machine with their own perceived settings. However, once they've sold you a machine with the sleep study settings they then hook you in to coming back and for a fee, adjust your machine to supposedly improve your sleep quality.

I wonder how many Aussies are paying for something they don't have to. The company I talked about in a previous post got annoyed because they had a review system. I quickly published a review about what had happened and TGA regulations which they were understandably unhappy about. I won't name them here but they are on the list of suppliers.

Your best advice comes from these forums!

As an aside. We are on a 'Buy Aussie' campaign at the moment but if you buy from an Aussie supplier you'll pay premium. US sites have much better deals even after factoring in shipping costs.

[Snooks]

The legal point for these suppliers revolves around machine settings. They can sell you a machine with default settings with no prescription. They can also sell you a machine with settings from the sleep study but this is technically with a prescription. This is where the prescription issue arises. They can't sell you a machine with their own perceived settings. However, once they've sold you a machine with the sleep study settings they then hook you in to coming back and for a fee, adjust your machine to supposedly improve your sleep quality.

I wonder how many Aussies are paying for something they don't have to. The company I talked about in a previous post got annoyed because they had a review system. I quickly published a review about what had happened and TGA regulations which they were understandably unhappy about. I won't name them here but they are on the list of suppliers.

Your best advice comes from these forums!

As an aside. We are on a 'Buy Aussie' campaign at the moment but if you buy from an Aussie supplier you'll pay premium. US sites have much better deals even after factoring in shipping costs.

Thanks for the info Holden4th.

I picked up a rental to try today until my machine comes next week and I asked the lady in there and she claimed that yes, you needed a prescription. I didn't delve further or push her because there was people around, but she was very ardarmant that it was essential.

Cheers