Government moves to extend cost recovery to Prostheses List

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The Department of Health has released a consultation paper on the introduction of cost-recovery for the Medical Services Advisory Committee.

The department claimed the decision was in response to a recommendation of the recent parliamentary inquiry into approval processes for new medicines and novel medical technologies.

The report of the parliamentary inquiry led by Trent Zimmerman MP was delivered in late November and included 31 over-arching recommendations.

The federal government has not delivered its response to the report that also recommended the adoption of a national approach to newborn screening and genomic testing and a range of other reforms.

Yet it has quickly moved to adopt just one of the ten sub-recommendations included in one of the over-arching recommendations.

According to the Department of Health, "This proposal seeks to address one of the key recommendations (recommendation 31) from the House of Representatives ‘Inquiry into approval processes for new drugs and novel medical technologies in Australia’ report titled The New Frontier – Delivering better health for all Australians that was tabled on 25 November 2021."

That over-arching recommendation 31 did include the potential adoption of cost-recovery for MSAC but only if it did "increase the speed and effectiveness of assessments."

The consultation paper includes proposed timelines for MSAC evaluations and outcomes but no evidence they will "increase the speed and effectiveness of assessments."

Recommendation 31 also called for the enhanced involvement of clinicians in MSAC evaluations, parallel processing with the TGA, sponsor hearings before the committee and international benchmarking of its processes and outcomes.

No announcement on progressing those recommendations.

The consultation paper says cost-recovery will be applied to commercial applicants, including companies seeking the reimbursement of codependent technologies, therapies funded through the National Health Reform Agreements, blood products and medical devices for inclusion on the Prostheses List.

Of the 31 over-arching recommendations, which include around 100 sub-recommendations, this is the one health minister Greg Hunt has decided to quickly progress.