The Medical Services Advisory Committee (MSAC) is the body that advises the Australian Minister for Health on evidence relating to the safety, effectiveness and cost-effectiveness of new medical technologies and procedures. In order for a doctor or other health professional to be reimbursed under the Australian Medicare system for a new procedure or new consultation an application must be made to MSAC. The application process can be quite prolonged and arduous for applicants.
In an effort to improve the process but maintain the same rigour in the assessment of applications the MSAC secretariat has instituted some process changes along with a new website. The reforms are an attempt to tailor the ‘pathway’ of an application depending on the complexity of the application and the ‘novelty’ of the service or technology. There is a 52-page document that outlines the new Process Framework. However here are a few highlights that will have relevance for new applicants.
The new application form is more complex and requires more up front information than the old application form and will require more resources to complete. Once it is submitted, it will be determined whether the application is suitable to progress. An initial ‘verification of the availability of evidence for assessment’ is made. At the moment how this actually happens is a little murky, however the intention appears to be that if evidence is obviously insufficient to achieve a successful outcome then the application should not proceed. From an applicant’s perspective it is better to get a quick ‘no’ than a long slow ‘no’ so this step may be considered as an improvement. It appears from the Flowchart of the process that most applications are expected to proceed.
Formerly known as the ‘Decision Analytic Protocol’ or the ‘Protocol’, this document outlines the clinical and economic questions that need to be answered in order to determine whether the new procedure or technology should receive public funding. It follows the format of ‘Population/Patients, Intervention, Comparator, Outcome’. This document was previously developed by the applicant. The new process requires that this is outsourced to a Health Technology Assessment (HTA) group with ‘close consultation’ with the applicant. There is no cost to the applicant for this.
While this process is too new to judge its success, it will be essential that the contracted HTA group thoroughly understands the new technology. If not mistakes may be built into the application process at the earliest stage.
There are mandated points of consultation between assessment groups and the applicant. There has certainly been an effort to improve communication. Recent experience has certainly shown that the MSAC Secretariat is demonstrating a willingness to be flexible and open that is very welcome.
For those who would like to delve more deeply into the changes, the MSAC Reform Key Differences Table is very useful.
While it is yet to be seen what differences the reforms will make to applicants, an MSAC application will continue to be a considerable undertaking. Our advice is to always undertake a preliminary assessment of the available evidence before embarking on the process. Please see www.medtechnique.com.au for more information.