PHI 24/10

This circular issued by the Private Health Insurance Branch contains information regarding the Review of Health Technology Assessment in Australia: Update on Implementation of Recommendations

Page last updated: 07 February 2013

Printable version of PHI 24/10 (PDF 30 KB)

4 May 2010

Review of Health Technology Assessment in Australia: Update on Implementation of Recommendations

Purpose

The purpose of this circular is to provide industry with an update on the implementation of the recommendations relating to prostheses listing arrangements from the Review of Health Technology Assessment in Australia (HTA Review).

Update on implementation of the recommendations

The implementation of the accepted Review recommendations is a key Government priority, with work to support implementation already underway.

As advised in PHI Circular 10/10 of 3 March 2010, recommendations 10, 11 and 12 of the HTA Review report outline specific changes to streamline the administration of the prostheses listing arrangements.

Recommendation 10 requires a review of the terms of reference (TOR) for the PDC and its subcommittees. The Department is currently working with key stakeholders to finalise the TOR, with the process expected to be completed in mid 2010.

Recommendation 10 also calls for channels of communication to be formalised between PDC and the Therapeutic Good Administration. Work has commenced on developing the protocols necessary for the implementation of this recommendation.

Recommendation 11 calls for the PDC to be restructured. The restructured committee will incorporate appropriate expertise in clinical practice, health policy, and health economics and will include a mechanism for the involvement of health consumers, health service providers, and the health insurance and health technology industries.

Activities are proceeding that are expected to allow the restructured PDC, tentatively referred to as the Prostheses Listing Advisory Committee, to be in place for the next prostheses cycle that commences August 2010.

Recommendation 12 will significantly streamline the Prostheses List arrangements, including a continuous application process with the Prostheses List continuing to be made every 6 months in August and February of each year. The Department is working to put in place a system that will enable applications to be submitted to the Department on a continuous basis. Further information on the continuous applications process will be made available to industry prior to the implementation of a new system.

Recommendation 12 also calls for finalisation of the establishment of groups of products with similar clinical effectiveness, establishment of a single benefit for products in each group and elimination of maximum benefits mandating gap payments. This work is expected to be completed by the end of 2011, and in place for the prostheses listing cycle commencing February 2012. The Department will be consulting industry about the grouping project over the coming months.

Implementation of the HTA Review recommendations will have no impact on the current Prostheses List cycle.

The Department will continue to communicate and consult with stakeholders about implementation of the HTA Review recommendations through PHI Circulars, existing committees and ad hoc meetings as necessary.

If you have any queries please contact Glenn Beaumaris on (02) 6289 6979, or Rose Marimon on (02) 6289 9459, from the HTA Review Implementation Section, Private Health Insurance Branch.

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2010 Private Health Insurance (PHI) Circulars.

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