Co-dependent and Hybrid Technologies
Codependent and Hybrid Technologies
Codependent and hybrid technologies can range from a single product with several components to several types of services linked along a clinical pathway. The use of diagnostic testing, including genetic testing, to refine patient selection and eligibility for high cost procedures, devices and particularly medicines, and the continued development of pharmacogenomics (also called ‘personalised medicine’), will provide a new approach for tackling disease, and challenges for their assessment.
Defining the technologies and determining the HTA approach
Health technologies are codependent if their use needs to be combined (either sequentially or simultaneously) to achieve or enhance the intended clinical effect of either technology. For example, a medicine-test combination where a new medicine seeking listing on the PBS may have a related pathology test that helps to determine the population group for that medicine.
Approach to HTA
A material codependency requiring a codependent submission arises when the Minister for Health requires advice from two different expert advisory committees because listing needs to occur under two separate funding programs (for example, PBS and MBS, or MBS and Prostheses List).
Codependent technologies’ assessments conducted to date have predominantly involved codependent medicines and pathology tests.
A critical element in the appraisal of a codependent technology is the need to consider the benefits of their joint use, as distinct to the benefit of each technology in isolation.
Applying for funding of Codependent Technologies
Applicants seeking to apply for funding for a codependent technology should address the PBAC and MSAC guidelines for codependent technologies as set out in the PBAC Product type 4 – Codependent technologies and Appendix 7 of the full MSAC Investigative Guidelines. Deadlines for integrated codependent submissions for meetings of MSAC and PBAC are provided here.
Hybrid health technologies combine the characteristics of different health technologies in one entity for example, a medicine or a biological or a medical device.
Approach to HTA
This type of technology can incorporate a combination of a medical procedure or a medicine or a biological or a device in the one intervention. Usually each of these components is assessed by a different advisory committee – MSAC, PBAC or PLAC. This presents challenges as to which reimbursement scheme is appropriate and thus which assessment process should be used.
The current approach to determining the most appropriate assessment pathway is informed by the classification established by the Therapeutic Goods Administration (TGA) in assessing it for entry on the Australian Register of Therapeutic Goods.
The department has established an HTA Team to assist potential applicants with codependent or hybrid technologies determine which is the most appropriate assessment pathway(s) and expert advisory committee(s) to undertake this type of specialised assessment.
Page currency, Latest update: 28 February, 2017