PHI 58/11

This circular issued by the Private Health Insurance Branch contains information on HTA progress update

Page last updated: 02 November 2012

Printable version of 58/11 (PDF 29 KB)

11 August 2011

HTA progress update


The purpose of this Circular is to inform stakeholders of updates to the prostheses listing arrangements as a result of implementing Recommendation 12 b-e of the Review of Health Technology Assessment in Australia (HTA Review).


Recommendation 12b-e of the HTA Review relates to changing the prostheses listing arrangements to establish and maintain groups of products with similar clinical effectiveness and a single benchmark benefit for each group of products, to remove maximum benefits from the Prostheses List, and to permit the establishment of new product groups into the future.

Previous circulars 82/10, 90/10, 27/11 and 47/11 provide further information on the HTA Review and Recommendation 12 b-e.

Work in progress

August 2011 Prostheses List

All Hip, Knee, Specialist Orthopaedic (arthroplasty and bone cement/bone substitute products - with the exception of special purpose tumour products and biologically active bone inductors)(Phase 1) and Ophthalmic products (Phase 2) have been grouped with appropriate benefits, reviewed by the HTA Consultative Committee and recommended by the Prostheses List Advisory Committee. These are reflected on the August 2011 Prostheses List.

Phase 2 and Phase 3

Sponsors with products in
  • Specialist Orthopaedic Plates and Screws and External Fixateurs
  • Vascular
  • Cardiac
  • Cardiothoracic
  • Urogenital
  • Spinal
grouping schemes have been given the opportunity to comment on proposed groups and benefits. Following clinician review of sponsor concerns, the final proposed groups and benefits for these products will be updated on the February 2012 Prostheses List.

Products in
  • Ear, nose and throat
  • Plastic and reconstructive
  • General and miscellaneous
  • the remaining Specialist Orthopaedic
grouping schemes and proposed benefits will be considered at the next HTA Consultative Committee meeting in September.

It is then anticipated that:
  • proposed groupings and benefits be sent to sponsors for comment in
  • mid September;
  • responses from sponsors will be due in mid-October; and
  • clinicians will review sponsors’ concerns.
We anticipate that the final grouping and benefits for these products will appear on the February 2012 Prostheses List, though this may change if further, appropriate consultation is required.

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2011 Private Health Insurance (PHI) Circulars.

Changing your e-mail address? No longer want circulars? Please email Private Health Insurance BranchTop of Page