PHA: Funding for new device highlights the need for reform to make room for innovation


Private Healthcare Australia says coverage of a new and less invasive valve for serious heart conditions is a good example of the need for reform.

MitraClip is a transcatheter mitral valve repair (TMVr) therapy that provides some people living with a leaky heart valve (mitral regurgitation) with a minimally invasive treatment option. This helps avoid the need for open-heart surgery.

The device is a small metal clip covered with a polyester fabric that is implanted in the mitral valve. The device repairs leaky mitral valves and is delivered to the heart through a small incision in the leg. The therapy works by grasping together portions of the leaflets, or flaps, of the mitral valve to reduce mitral regurgitation, which allows the heart to pump blood more efficiently, thereby relieving symptoms and improving patient quality of life.

Private Healthcare Australia said the device is expensive - more than $26,000 just for the device and delivery system - and it will be covered for private patients with appropriate private health insurance cover from 1 July.

“This new device will improve quality of life for hundreds of Australians over the next few years, reducing the need for open-heart surgery,” said Dr Rachel David, CEO of Private Healthcare Australia.

“Medical technology can be lifesaving, improve quality of life and provide massive benefits to Australian families. I’m pleased that new, innovative technology such as MitraClip is available for private patients. This device is expensive, but it provides value to the consumer and to the Australian community.”

Private Healthcare Australia said it is currently campaigning for lower prices for generic medical devices that can be significantly higher in Australia compared to the UK, South Africa and New Zealand.

“MitraClip is actually a good example of why we need to reform prices. We need to stop paying over the odds for older, generic technology which has become commoditised and invest more into new, innovative technology and reward innovation,” said Dr David.