In October 2017, the Government and the Medical Technology Association of Australia (MTAA), as advocates for Australia’s innovative medical technology sector, reached an agreement to:
- promote the sustainability of privately insured health care through rebalancing the costs of medical devices to privately insured patients, to help keep private health insurance affordable for all Australians;
- support a viable, innovative and diverse medical technology sector in Australia and local jobs; and
- improve the value of private health insurance for consumers by reducing benefits for prostheses on the Prostheses List.
Hibernation of the MTAA Agreement
In response to COVID-19, the Minister for Health, the Hon Greg Hunt MP, has agreed to pause all Prostheses List reform work covered under the Strategic Agreement with the Medical Technology Association of Australia (MTAA) and Prostheses List reviews for a period of up to 12 months commencing from 1 April 2020.
A Questions and Answers (Q&A) document has been prepared to provide all stakeholders with clarity on the impact of the hibernation on the work related to the Prostheses List.
The Q&As were updated in July 2020 to include advice on Prostheses List fees.
The Q&A document and other information related to the MTAA Agreement are available.
Australian Government and MTAA Agreement 2017 – 2022: High Level Workplan
The Agreement Workplan will form the basis of the work the Government intends to undertake to:
1. Support sector stability and sustainability
2. Reduce the time to market for medical devices
3. Ensure Australian patients have access to safe, effective, and cost effective innovative medical devices in the private sector
4. Improve the transparency and efficiency of the Prostheses List arrangements
5. Recognise superior clinical performance
6. Support Australian medical technology innovation
Prostheses List Review of the General Miscellaneous Category
The Department of Health is undertaking a review of the General Miscellaneous category of the Prostheses List to determine whether items listed in that category (or a subset of items) should continue to be listed on the Prostheses List. In doing so the Review will take account of the overall purpose of the Prostheses List. In line with the hibernation of the MTAA Agreement, the Review has been placed on hold.
Cardiac ablation catheters for atrial fibrillation
As at 1 March 2019, cardiac ablation catheters for atrial fibrillation are included on Part C of the Prostheses List.
The PLAC report Cardiac ablation catheters: consideration of Prostheses List inclusion and its attachments are listed below:
The initial economic evaluation found that cost-effectiveness was most sensitive to the price of the devices. The economic analysis made assumptions on prices of devices ranging from $2,340 for a simple mapping catheter through to $6,000.
An extended economic evaluation was undertaken incorporating advice provided by MSAC at its meeting of 22-23 November 2018. The evaluation was provided to the MSAC Executive and the PLAC to inform consideration of a cost-effective benefit at which to list cardiac ablation devices for the treatment of atrial fibrillation. This report is provided below:Medical Services Advisory Committee website (www.msac.gov.au/internet/msac/publishing.nsf/Content/1580-public)
Questions or comments
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Two year clinical evidence requirements
PDF version: Two year clinical evidence requirements (PDF 73 KB)
Word version: Two year clinical evidence requirements (Word 18 KB)
Prostheses List Reform Governance Group
The Governance Group will monitor the implementation of the Australian Government – MTAA Agreement and oversee the operation of the three Industry Working Groups. It will define performance data to inform the evaluation of the Agreement and consider the management of commercially sensitive information during this program of work. The Agreement will be reviewed by the Governance Group in 2021.
Industry Working Groups
As part of the agreement with the MTAA, the Government committed to establish three working groups:
- Revised Benefit Setting and Review Framework Industry Working Group to develop a revised framework for benefit setting and benefit review.
- Cardiac Technical Support Services Industry Working Group to determine how technical support services for active implantable cardiac devices should be funded.
- Quality of Information and Guidance Industry Working Group to improve the quality of information provided to applicants in the Prostheses List – Guide to Listing and Benefits (the Guide) and the Prostheses List Management System (PLMS).
PDF version: Quality of Information Terms of Reference (PDF 390 KB)
Word version: Quality of Information Terms of Reference (Word 207 KB)