MTPConnect welcomes Prostheses List reform recommendations

16 May 2017

MTPConnect welcomes the recently released Community Affairs Reference Committee report into “Price regulation associated with the Prostheses List Framework”. The report provides 16 recommendations to reform the process, with the aim of addressing the identification of the Prostheses List’s contribution to the rising price of health insurance premiums.

As stated in the report, the Prostheses List was introduced as a measure to stabilise uncontrolled and uncontained growth in the private sector by setting the price paid for prostheses by private health insurers, however work is needed in ensuring that the sector understands its aims and benefit.

The committee conducted public consultations and received 45 submissions to the report from stakeholders including medical device manufacturers, private health insurers, private hospitals, practitioners, consumer groups and government departments.

Recommendations of the report include:

  • Improved coordination between the TGA and the Prostheses List Advisory Committee including implementing appropriate coordination of health technology assessment processes
  • That where the Commonwealth decides that a prostheses registry is needed, the Parliament should ensure that the registry is legislated for and collection of data is made compulsory
  • Action is needed to reduce the prostheses costs and that savings should be delivered as soon as possible and have an evidence base
  • That the Department of Health undertake further analysis and consultation, including with consumers, to determine the most appropriate benefit setting model or models
  • That the Prostheses List Advisory Committee be required to review the group prices for prostheses when applications for new comparable devices are received which request listing at a lower price than the existing benefit level for that group of devices
  • That the Prostheses List Advisory Committee investigate a mechanism for the reimbursement of medical devices not currently eligible for inclusion on the Prostheses List
  • That the nature and cost of services associated with a medical device on the Prostheses List be disclosed separately to the cost of the device

Download the Senate Inquiry report.