Multiparametric MRI (mpMRI) has emerged as a critical tool in the diagnosis and risk stratification of prostate cancer (PCa). In 2018, the Australian Medicare Benefits Schedule (MBS) was updated to include rebates for prostate mpMRI. This study evaluates the impact of this funding change on referral patterns, indications, and diagnostic yield at a single Victorian centre.

A retrospective cohort analysis was performed on mpMRI referrals over two timeframes: 30 months pre- and 54 months post-MBS listing. All referral indications were included. Patient demographics and clinical parameters (age, PSA, PSA density, prostate volume, PIRADS score) were analysed. Statistical tests included Shapiro-Wilk for normality, followed by Mann-Whitney U or t-tests, with p<0.05 considered significant.

There was a 13.8% annual increase in mpMRI referrals post-MBS update, with urologist-initiated referrals rising by 125%. Diagnostic scans increased from 42% pre-funding to 70% post-funding. PIRADS 4–5 lesion detection also increased, suggesting improved targeting and utilization.

The 2018 MBS update significantly influenced referral patterns and clinical utility of mpMRI for PCa. These findings underscore the importance of funding policy in shaping diagnostic practice and highlight the need for continued evaluation of mpMRI’s integration into PCa diagnostic algorithms.