HTA for Australian Government subsidy

Main subsidy programs

A manufacturer or sponsor of a health technology can apply for it to be listed on one of our subsidy programs, such as the:

• Pharmaceutical Benefits Scheme (PBS)
• Medicare Benefits Schedule (MBS)
• Prescribed List (PL).

This reduces the cost to Australians, which means more people can access the technology.

Purpose of HTA for subsidy

The Australian Government cannot financially support every new health technology that comes onto the market.

We use HTAs to direct Government subsidies to health technologies that are clinically relevant, cost effective and safe.

The HTA process provides our principal HTA committees with information they use when providing advice to the Government on whether a health technology should be subsidised.

What HTAs assess for

HTAs for subsidy purposes analyse evidence of the benefits, harms and costs of a health technology to determine its value. Value involves:

• clinical effectiveness – does the health technology work?
• safety – is it safe to use?
• costs – how much will it cost to use?
• economic implications – is it good value for money?
• other information – what are the relevant clinical needs, or social or ethical issues?

Assessors measure health impacts and costs against what is already used (called the comparator). This helps decide whether the extra benefits from a new health technology are enough to justify any extra costs to the healthcare system.

Principal HTA committees

Three principal health technology assessment committees advise the Minister for Health about subsidy decisions.

Codependent technologies

A codependent technology is a medical technology or service that relies on another technology to work properly. The principal HTA committees work together as needed to assess codependent technologies.

An example is a test (which MSAC considers) that guides the use of a medicine (which PBAC considers).

Sponsors need to submit codependent applications to each relevant committee.

How to apply

See the following guides for details on how to apply for listing on the:

• PBS – Procedure guidance for listing medicines on the PBS
• MBS – How to apply for public funding
• PL – Prostheses List Guide and Prostheses List Management System.

Monitoring and review of health technologies

We have systems and process in place to review and monitor the use of health technologies.

Therapeutic goods

The TGA’s postmarket monitoring system continually evaluates the safety, efficacy or performance of therapeutic goods that are available on the market.

PBS-subsidised medicines

Post-market reviews of PBS-subsidised medicines are part of our commitment to the quality use of medicines in Australia.

MBS items

We carry out an ongoing review of MBS items through the MBS Continuous Review. We report to MSAC on predicted versus actual use of MBS items, to check if they are being used as intended.