Private Healthcare Australia has used its submission to the health technology assessment review to argue for 'competitive neutrality' in evaluating new health technologies and the application of PBS-like policies to medical devices.
The reform of the framework for the private funding of medical devices has been contentious for several years. While there is broad agreement on the need for reform of the Prostheses List, which is the legislated framework, there is disagreement on what form it should take. The current first round of reform scheduled for implementation on 1 July was recently delayed in response to concerns over the risk of unintended consequences.
In its submission, Private Healthcare Australia, the association representing Australia's private health insurance sector, has acknowledged that most of the review's terms of reference relate to medicines and exclude medical devices.
However, it says the inconsistent application of HTA based on technology "results in poorer quality care for consumers, as technologies which are assessed differently are much more likely to have differing availabilities, differing access regimes, and different costs and benefits."
"Each of these differences may result in skewed incentives for providers, and consumers receiving suboptimal treatment."
On competitive neutrality, Private Healthcare Australia says it would help "ensure that consumers are offered the best technology for their health condition."
"This would mean that the assessment and funding processes for medical devices would be aligned with pharmaceuticals, reducing distortions in the market," it says, adding that it recommends a range of PBS-like policies, including reference pricing, a framework that ensures payers can take of advantage of competition, and restrictions that limit usage.
" It’s difficult to marshal an effective argument why medical devices and pharmaceuticals should be treated differently, and PHA urges the HTA Review to recommend similar approaches be used for different technologies to improve public value and reduce perverse incentives."