The Australian market is always a desirable one for manufacturers of medical devices. Like every other country Australia is facing demographic changes combined with high expectations of health care from its citizens. As the impacts of an aging population are being felt in both the public and private sectors there are flow on implications for medical devices. This is playing out in a number of ways.
Increased focus on health technology assessment (HTA) of medical devices.
The Medical Services Advisory Committee (MSAC) has become the default HTA agency for non-pharmaceutical procedures, although it also has a role in the assessment of diagnostic tests for access to Pharmaceutical Benefits Schemes (PBS) drugs. While its’ role is primarily to evaluate new medical procedures, tests and attendances for inclusion on the Medical Benefits Schedule (MBS), it is increasingly been recruited to evaluate first in class/breakthrough device or new devices that is likely to have a significant financial impact on the health system. Therefore, we are likely to see more referrals from the Prostheses List application process to MSAC.
MSAC is also involved in assessments related to national health policies such as the National Diabetes Services Scheme
Focussed HTA for Prostheses List Devices
This is a streamlined HTA process for Prostheses List devices that are requesting a new clinical category or an increased benefit. This process for this is likely to be refined in 2020. Unless there is some structural change to the Prostheses List, this is likely to be a permanent fixture.
MSAC Applications
There is no major reform on the horizon for MSAC at present, however the process is always a little daunting and it is wise for applicants to be cognizant of the guidelines and the strict timelines imposed. As always it is wise to conduct a feasibility assessment with an experienced organisation prior to embarking on a full submission.
MBS Review
The MBS review has been ongoing for a number of years. It aims to streamline the MBS and ensure that all item numbers relate to clinically effective procedures and are up to date. Expect to see consolidation of many procedural items which may have flow on effects to the devices used in those procedures.
Politics 2020
As the Minister of Health has placed considerable political capital in keeping private health insurance premium increases under 3 percent, expect continuous lobbying from the private health insurance industry, the private hospitals and the medical technology industry. For a long time the private health insurance industry has dominated this space, but other players are now speaking out to demand that the insurers take some responsibility for limiting premium increases. This will not be resolved anytime soon.
MedTechnique Consulting has helped many organisations to navigate the Australian healthcare landscape, gain market access and submit successful reimbursement applications. If you have any questions or would like to learn more about how we can help your organisation access the Australian market, contact us via email: info@medtechnique.com.au or phone:+ 61 448 058 00.
Author: Sarah Griffin, Director of MedTechnique Consulting, experts in medical device reimbursement and market access in Australia. Sarah is a health economist, reimbursement strategist, health policy advocate and experienced speaker. Connect with Sarah on LinkedIn Sarah Griffin LinkedIn
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