2016 is shaping up to be ‘interesting’ for those companies supplying medical devices into the generally profitable and stable Australian market. It’s a federal election year with health funding sure to be a major area of debate. To add further to the excitement, a number of federal government reviews are underway, the two most significant being the review of private health insurance and the review of the Medical Benefits Schedule.
The Private Health Insurance review will almost certainly recommend some reform of the current ‘Prostheses List’ system which guarantees suppliers a specific benefit for implantable devices for privately insured patients. What precise changes will be recommended is unclear as yet.
The Medical Benefits Schedule (MBS) is the list of medical procedures which are subsidized by the Australian Medicare System. The review is intended to modernize the MBS by removing obsolete procedures or those not supported by clinical evidence. However the cumbersome process of listing new procedures is not included in the review. The review has generated much publicity and is likely to provoke further uproar as specific recommendations impact on interest groups.
In addition, a review of the Medical Services Advisory Committee (MSAC) processes is currently underway with the initial proposals recently made public. MSAC is the body that makes recommendations on the clinical and cost effectiveness of new medical procedures and recommends whether they should be included on the MBS. The process is lengthy, expensive and is often criticized for lack of transparency and excessive bureaucracy.
Amongst this complexity the Australian market also remains an exciting place to do business. Successfully navigating the Prosthesis List and MSAC processes results in guaranteed mandated pricing for medical devices and a profitable and stable business environment. It’s certainly challenging but the investment is worthwhile on successful reimbursement listing. It’s essential to get it right and the support of an expert reimbursement specialist is essential.
Want to learn more? Sarah Griffin, Principle of reimbursement and health economics specialists MedTechnique will be presenting at the Asia Pacific Devices Summit in San Francisco, CA, March 10-11. Sarah will lead an in depth session on ‘Reimbursement Opportunities in the Asia Pacific‘. Why not join us and meet Sarah face to face. The summit features in-depth presentations from leading Asian experts in regulatory, reimbursement, clinical trials and much more. It’s a must attend event for anyone serious about succeeding in Asia. Visit the conference website to register today and gain a $495 early bird discount.
About Sarah Griffin – Medtechnique Consulting
Sarah has 25 years’ experience in international health, including health policy and legislation, health economics, health insurance, medical finance and reimbursement systems and government relations. She has held senior international roles within health insurance and medical technology. She now specializes in reimbursement strategy, health economics and advocacy to governments and insurers within Australia and New Zealand.