Prostheses List reforms and reviews
We are making changes to the Prostheses List to improve access to medical technology, and make sure it is efficient, transparent, and keeps up with technological advances. Read about our reforms and reviews of the Prostheses List.
The Australian Government and the Medical Technology Association of Australia (MTAA) are looking to change Prostheses List arrangements to improve access to medical technology.
The agreement supports sponsors and suppliers of medical devices, and aims to:
- improve private health insurance stability and sustainability
- reduce the time it takes for medical devices to become available on the market
- ensure Australian patients have access to safe, effective, cost-effective and innovative medical devices in the private sector
- make Prostheses List arrangements more efficient and transparent
- recognise superior clinical performance
- support Australian medical technology innovation.
A number of industry working groups supported our reform work. The Prostheses List Reform Governance Group monitors and reviews the MTAA agreement.
The Industry Working Group on Revised Benefit Setting and Review Framework was asked to develop and provide a final report to the Minister for Health and MTAA Chairman by 30 June 2020 on options for a revised framework for setting and reviewing benefits for devices on the Prostheses List.
This report describes the proceedings of the Revised Benefit Setting and Review Framework Industry Working Group (BSRIWG) over 8 meetings held between April 2018 and February 2020.
You can now have your say on possible options for future reforms and improvements to the Prostheses List. We’re seeking input from consumers, medical device sponsors, private hospitals, private health insurers, clinicians and anyone else with an interest.
Read our consultation paper, which contains questions at the end of each section. These questions are a guide. You are welcome to provide feedback, with appropriate evidence, on any matter that will improve the Prostheses List. This could include issues not mentioned in the paper.
Please email us your feedback by 5pm AEST Monday 15 February 2021.
We review prostheses or groups of prostheses to make sure they continue to be grouped and funded appropriately.
Review of the General Miscellaneous Category
We worked with EY to review the General Miscellaneous Category of the Prostheses List, to determine whether items listed in that category should remain listed.
To make sure we have a strong evidence base for the review, we sought input from:
- device sponsors
- private hospitals
- private health insurers
- other interested parties.
For more information, see:
- PHI circular 86/20
- PHI circular 85/20
- PHI circular 11/20
- PHI circular 09/20
- PHI circular 81/19
- PHI circular 68/19
- terms of reference.
Review of Part B of the Prostheses List
We are currently reviewing the arrangements for human tissue products listed on Part B of the Prostheses List. We expect to receive the final report soon.