What the review is about
Spinal fusion cages and plates are used in some types of spinal fusion surgery.
In January 2026, we published clarified groupings’ descriptors and definitions for PL grouping 13.10.01 – Interbody Fusion Cage, Integral Fixation, 13.10.02 – Interbody Fusion Cage, No Integral Fixation, 13.05.01 – Plate, Integral Fixation and 13.05.02 – Plate, No Integral Fixation.
In 2024, we asked stakeholders for feedback on the clarified groupings. During consultation, some stakeholders claimed integral fixation cages offer superior clinical benefits compared to no integral fixation and should be appropriately reimbursed to reflect this. Other stakeholders supported the clarity in the proposed definitions.
In 2025, the Spinal and Neurosurgical Expert Clinical Advisory Group (SNECAG) recommended we undertake a post-listing review of devices in groups 13.10.01 and 13.10.02. The purpose of the review is to assess the current PL benefit settings for spinal cages are proportionate to the clinical-effectiveness of the devices. The review will also consider spinal plates, listed in 13.05.01 and 13.05.02.
Objective
The objective of the review is to consider whether the current benefits payable for the spinal cages reflect the comparative clinical evidence, construct use in practice, and cost-effectiveness of these devices. The review will also consider spinal plates, listed in 13.05.01 and 13.05.02, and bone screws listed in 13.01.03.
The devices in scope of the review are:
- 13.10.01.01 – Fusion Cage – Interbody, Integral Fixation – Cervical
- 13.10.01.02 – Fusion Cage – Interbody, Integral Fixation – ThoracoLumbar/Lumbar
- 13.10.02.01 – Fusion Cage – Interbody, No Integral Fixation – Cervical
- 13.10.02.02 – Fusion Cage – Interbody, No Integral Fixation – ThoracoLumbar/Lumbar)
- 13.05.01.01 – Plate – Integral Fixation – Cervical
- 13.05.01.02 – Plate – Integral Fixation – ThoracoLumbar/Lumbar/Lumbosacral
- 13.05.02.01 – Plate – No Integral Fixation – Cervical
- 13.05.02.02 – Plate – No Integral Fixation – ThoracoLumbar
- 13.01.03 – Bone Screws – Standard
The review process
We received feedback on the scope and research questions for the spinal fusion cages post listing review as part of the recent stakeholder consultation.
Following stakeholder feedback, we have refined the objective, the scope and research questions to provide greater clarity on the scope of the review. The updated objective broadens the focus beyond clinical effectiveness to also consider construct use in practice and cost‑effectiveness, and clarifies that spinal plates and bone screws are included where they form part of the relevant construct. The research questions have been updated accordingly to support a more comprehensive, construct‑level assessment, including consideration of available clinical and economic evidence.
These refinements are intended to improve transparency and ensure the review reflects real‑world use and reimbursement considerations, while maintaining the overall purpose of the review.
We have notified sponsors and key stakeholders via email about these changes. Sponsors and stakeholders were given an opportunity to provide further input, where relevant, to the objective, scope and research questions.
The review will follow the process outlined in the post-listing review framework, exploring the following:
- What mix of individual devices/components are used for integral fixation versus no integral fixation?
- What does the available clinical evidence indicate about differences in clinically meaningful outcomes between integral fixation and no integral fixation?
- What does the available economic evidence indicate about the comparative cost effectiveness of integral fixation compared to no integral fixation?
- Are the PL benefits and/or groupings of the devices appropriate?
Timeline
- January – March 2026 – Stakeholder consultation.
- June 2026 – ToR finalised.
- July 2026 – Stakeholder consultation
- August 2026 – Draft report.
- August – September 2026 – Stakeholder consultation on draft report.
- November 2026 – Final report.
- December 2026 – Present final report to MDHTAC for advice.
Result of the review
This review is ongoing. We will release the outcome when the review is complete.
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