The Medical Services Advisory Committee (MSAC) is an independent non-statutory committee established by the Australian Government Minister for Health in 1998.
MSAC appraises new medical services proposed for public funding, and provides advice to Government on whether a new medical service should be publicly funded (and if so, its circumstances) on an assessment of its comparative safety, clinical effectiveness,cost-effectiveness, and total cost, using the best available evidence. Amendments and reviews of existing services funded on the Medical Benefits Schedule (MBS) or other programmes (for example, blood products or screening programmes) are also considered by MSAC. Listen
Surgery appears to lead to better outcomes if there are ongoing symptoms after three to six months of conservative treatment.  Laminectomy is the most effective of the surgical treatments.  In those who worsen despite conservative treatments surgery leads to improvement in 60–70% of cases.  Another procedure using an interspinous distraction device known as X-STOP was less effective and more expensive when more than one spinal level is repaired.  Both surgical procedures are more expensive than medical management. 
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