4.5.27 Non-established, new or emerging treatment & services (NeNETS)
4.5.27.1 Ketamine infusions | 4.5.27.2 Medicinal cannabis
WorkSafe can consider paying the reasonable costs of NeNETS (equipment, medications, prostheses, procedures or surgeries) only in exceptional circumstances when required as a result of a work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. injury or illness.
When reviewing the reasonableness and appropriateness of NeNETS requests WorkSafe relies on evidence-based information and decisions guided by:
- Medical Services Advisory Committee (MSAC)
- Medicare Benefits Schedule (MBS Medicare Benefits Schedule)
- Prostheses List Advisory Committee (PLAC)
- Department of Health and Ageing Prostheses List
- Pharmaceutical Benefits Advisory Committee (PBAC)
- Pharmaceutical Benefits Schedule (PBS)
- Australian Register of Therapeutic Goods (ARTG The Australian Register of Therapeutic Goods (ARTG) was established under the Therapeutic Goods Act 1989. The ARTG is a computer database of therapeutic goods. Therapeutic goods are divided broadly into two classes - medicines and medical devices. Unless exempt, therapeutic goods must be entered as either 'registered' goods or 'listed' goods before they may be supplied in, or exported from Australia. Listed goods are assessed for compliance with standards relating to quality, safety and manufacture. Registered goods which include prescription medications are evaluated for quality, safety and effectiveness.).
Policy
Refer to policy for Non-established, New or Emerging Treatments & Services including information about:
- who can provide services
- what WorkSafe will and will not paid for
- information required to pay for services.
4.5.27.1 Ketamine infusions
In Australian medical practice, ketamine is occasionally used as an anaesthetic in surgical and trauma settings.
Outside of anaesthetic use there is insufficient evidence to support the use of ketamine as a first line treatment to treat chronic non-cancer pain.
There is, however, evidence to suggest the use of ketamine infusions in limited circumstances.
WorkSafe may pay for ketamine infusions in the following instances:
-
Where patients have failed to respond to first-line treatments for chronic non-cancer pain.
-
To reduce opioid use in patients with limited options for managing chronic non-cancer pain.
-
To reduce the use of opioids needed following a surgical procedure.
Other forms of ketamine or ketamine infusions for the treatment of conditions or clinical indications that do not form part of the Ketamine infusion guidelines, will be assessed in line with the NeNETS policy.
Guidelines
Refer to the Ketamine infusion guidelines for more information, including:
-
What WorkSafe can pay for
-
Services WorkSafe will not pay for
-
How much WorkSafe can pay
-
Who can provide these treatments
-
Accessing treatment
-
Treatment delivery expectations.
These guidelines should be read with:
4.5.27.2 Medicinal cannabis
Medicinal Cannabis refers to the use of pharmaceutical products deriving from the cannabis plant or chemicals contained within it.
WorkSafe may consider paying the reasonable costs of medicinal cannabis rare circumstance where it is an appropriate treatment for chronic non-cancer pain (CNCP) for a period of time, when all other reasonable treatments and services have been exhausted.
Requests made for exceptional circumstances for conditions other than CNCP (e.g. psychiatric, non-pain physical conditions or cancer) will be assessed under the non-established, new or emerging treatment or service (NeNETS) policy.
Policy
Refer to the Medicinal cannabis policy for more information including:
- who can prescribe medicinal cannabis
-
evidence for its use
-
the information required from the treating medical team
This policy should be read in conjunction with: