A patient group is calling on health minister Greg Hunt to include catheter ablation on the Prostheses List.
According to hearts4heart CEO, Tanya Hall, “Despite being considered the best possible treatment for many people with atrial fibrillation, catheter ablation does not fit the out-dated criteria of the decades-old Prostheses List, so patients continue to miss out on this important procedure.”
Catheter ablation is surgery that seeks to correct electrical short-circuits that make the heart beat irregularly. It involves the use of a non-implantable medical device that cost around $9,000. As a non-implantable device, with the catheter removed from the body after the procedure, it does not meet the criteria for inclusion on government's Prostheses List. Inclusion would compel private health insurers to fund the procedure.
It is understood some private insurers will cover the device under contractual arrangements with hospitals. However, in the absence of any contractual arrangement, the insurer may cover the patient’s hospital stay, theatre time and professional fees, but not the ablation catheter itself.
“Minister Hunt is aware that the Prostheses List has not kept pace with 21st Century medical technology. We call on him to intervene without delay,” said Ms Hall, who was speaking at the launch of a new report, Time to change the beat, calling for a raft of changes in the diagnosis and treatment of atrial fibrillation.
“Australians with atrial fibrillation deserve the best chance at a healthy life and, for many, that can be achieved by early catheter ablation treatment,” added Ms Hall.
In addition to the inclusion of catheter ablation on the Prostheses List, the report calls for a new Medicare item number for GPs to screen high risk patients, funding for a community awareness campaign, adoption of soon-to-be updated treatment guidelines, and measures to support greater patient adherence to medication.
The report says the non-inclusion of catheter ablation on the Prostheses List is also forcing more privately insured patients into the public hospital system.
Former health minister Sussan Ley revamped the Prostheses List Advisory Committee (PLAC) and gave it responsibility for reforming the arrangements for listing prostheses. It remains a difficult area of policy with government pursuing further reforms having already imposed over $80 million in price reductions.
According to a leading heart rhythm experts, Dr David O’Donnell from the Austin Hospital in Melbourne, “Catheter ablation is a very effective treatment for a large number of patients who would otherwise suffer from debilitating chest pounding, struggle to perform day-to-day activities, and face a heightened risk of stroke, heart failure, and dying because of atrial fibrillation.
“Generally speaking, there is a window of opportunity after symptoms begin in which ablation is most successful. In order to reduce the chances of atrial fibrillation returning, the need for hospitalisation, or the progression of structural changes to the heart, ablations should be performed as soon as possible,” added Dr O’Donnell.
The Time to change the beat was prepared with the support of a variety of stakeholders, including clinicians, patient and pharmacy groups, pharmaceutical and medical device companies.