Evaluation of the National External Breast Prostheses Reimbursement Program

2.6 Summary of results

Page last updated: 05 November 2010

Overall, the vast majority of people consulted considered the program to be operating well, and to be meeting the needs of women who require a breast prosthesis following a mastectomy for breast cancer.

The administration of the program appears to be operationally sound, and relationships between Medicare Australia and the Department of Health and Ageing appear to be productive and to facilitate the resolution of any policy or operational questions which have arisen during the year. The administration of the program will be discussed further in chapter 3.

All interview participants considered that the program provided essential support to address a significant need for women who have had a mastectomy. The majority of women who participated in the consultation were satisfied with the program and with their interaction with the program through Medicare Australia. The impact of the program on women and their perceptions of the program are discussed further in chapter 4.

At the same time, several key themes emerged in consultation across the broad range of stakeholders – clinical, organisational, or individual.

One theme was the promotion of the program, to both consumers and health care providers. While those who had accessed the program appreciated its existence, it was felt that the promotion of the program could be improved to ensure that older women, Aboriginal and Torres Strait Islander women, and women of a culturally and linguistically diverse background were aware of the program. A number of respondents also considered that awareness amongst clinicians was relatively low, other than amongst breast care nurses. Some people felt that GPs, breast physicians and breast surgeons might be better able to assist women if they had more awareness of the program.

A second theme was the requirement for women to pay for their prosthesis and then claim reimbursement. There were some reports of financial hardship experienced by women; a few of these were individual comments provided anonymously in the survey, while in interviews a number of people expressed general (but unsubstantiated) concerns that other women may not be able to afford the initial cost of the prosthesis. The number of respondents actually reporting financial hardship for themselves within the survey was small, and it is therefore not possible to quantify whether this is a significant hardship more generally for women.

A third theme was the access to the program by particular groups of women, such as Aboriginal and Torres Strait Islander women, and women of culturally and linguistically diverse backgrounds. As program information is only available in English, it was identified that many women who do not speak English may not be receiving information about the program. While Aboriginal and Torres Strait Islander women have lower rates of breast cancer compared to the non-Indigenous population, it was also suggested that Aboriginal and Torres Strait Islander women, particularly in rural and remote communities, may not be aware of or accessing the program.