Searching for a Crohn's Doc in Melbourne, Australia

Where do you live now, Michael?

You can't just self-refer to see a specialist here. You'll need to get a referral from a local g.p. or another local specialist.

I recommend you ask your current gastro (if you trust him / her) to recommend a doctor for you, because it would be beneficial for your care if your own doctors were friends and could communicate easily between themselves. Failing that, I suggest you make an appointment with your local gp as soon as you arrive in Australia (bearing in mind that, depending on what area you live in, it can take a while to get a gp appointment if you're new to the area) and try to get yourself referred to one of the senior gastros at the MAJOR teaching hospitals: in other words, not a shonky suburban hospital, but one that is affiliated with one of the major medical schools, such as University of Melbourne or Monash University.

Deakin has a medical school too, but it's new and not as well established, so I'd stick with Melb or Monash if I were you.

All the best,

Ivy.

Oh! And once you know that information, it might be a good idea to tell us what medications you're on, because there's no guarantee you'll be able to keep taking them if you end up being able to access subsidised medicine through our NHS.

I'm thinking, especially, of things like Remicade and Humira, which are highly regulated... and Cimzia which, as far as I know, hasn't made it onto the subsidised list here. I don't even think it has been properly approved for use in Crohn's patients here yet.

Well, I'm glad you talked to us. It's good that you're doing your research before you commit to moving.

Imuran is on the subsidised list here, but you need to know that Entocort ISN'T. Chances are you may need to move over to Pred, unless you have a kindly insurance scheme, or stumble across a doctor who is able to convince the local hospital to give it to you for free. You'd need to be in a big, well-funded hospital for this, as well as lucky, and would need good reason to be on Entocort instead of Pred; e.g. dramatically reduced bone mass.

Rem / Humira will be tricky. If you were a public, local patient, you'd need to be on Imuran for at least three months, and still have a CDAI of at least 300, as well as a lot of other clinical documentation. I don't know what the procedures are for international residents, especially if they've started the anti-TNFs overseas before coming to Aus. We tend not to start treatment with these highly expensive drugs in Australia; we tend to start on pred and immunosuppressants, and only graduate up to the anti-TNFs if we're unresponsive to those older and cheaper therapies.

I think that this is something you'll need to discuss thoroughly with your doctor, Embassy and insurance company. Whatever they tell you, make them COMMIT and put it in writing, as you don't want to start Rem and lose access to it once you move here, and then end up reacting to it when you do go home and restart it.

I.

No, I don't live in Melbourne. I'm reasonably familiar with the city, though.

I can't recommend a good private insurance company for you, sorry. I'm in the public system and am happy there, and have no reason to cross over.

The privately insured are in the minority here.

Definitely do that research. I'd hate for you to get over here, and get sick because you'd had to change your treatment.

btw, are you planning to become an Aust citizen, or are you just going to be visiting?

I.

Congratulations!!!

So is that "yes" on the citizenship?

Hi Ivy,

Imuran is on the subsidised list here, but you need to know that Entocort ISN'T. Chances are you may need to move over to Pred, unless you have a kindly insurance scheme, or stumble across a doctor who is able to convince the local hospital to give it to you for free. You'd need to be in a big, well-funded hospital for this, as well as lucky, and would need good reason to be on Entocort instead of Pred; e.g. dramatically reduced bone mass. Rem / Humira will be tricky. If you were a public, local patient, you'd need to be on Imuran for at least three months, and still have a CDAI of at least 300, as well as a lot of other clinical documentation. I don't know what the procedures are for international residents, especially if they've started the anti-TNFs overseas before coming to Aus. We tend not to start treatment with these highly expensive drugs in Australia; we tend to start on pred and immunosuppressants, and only graduate up to the anti-TNFs if we're unresponsive to those older and cheaper therapies. said...
/quote]

So, if I provide proper clinical documentation to a gastro in Melb from my current doc, would that be sufficient to receive Entocort or Remicade? Even if I have to pay full price for it?? Would you know perhaps know anyone that is currently on Remicade in Victoria that I could contact?

Thanks!

Michael

Post Edited (MichaelR) : 12/8/2009 9:52:49 PM (GMT-7)

I appreciate your response. Thanks.

ps. The link has contact details of an organisation you can ask - initially, anyway - about your eligibility for treatment.

Don't thank me yet. It made *me* go cross-eyed with boredom and confusion, and I know how the system works here!!

Have fun...

I.