Recommendation 1
5.4 The committee recommends that the
Prostheses List Advisory Committee, in consultation with stakeholders, develop
and publish a formal work plan with defined agreed targets, activities,
timeframes, indicators and outcomes to assist stakeholders to better understand
and participate in the reform process.
Recommendation 2
5.5 The committee recommends that the
department immediately implement better and more robust coordination between
the Therapeutic Goods Administration and the Prostheses List Advisory
Committee, including implementing appropriate coordination of health technology
assessment processes to ensure that applications to list on the Prostheses List
as a minimum have a concurrent application for listing on the Australian
Register of Therapeutic Goods.
Recommendation 3
5.6 The committee recommends that clinical
input through Clinical Advisory Groups remain an integral part of the
Prostheses List Advisory Committee and the Prostheses List decision making
process to ensure that safety and effectiveness of medical devices remains a
primary consideration in decisions about inclusion on the Prostheses List.
Recommendation 4
5.7 The committee recommends that the
Government assess the resources needed to develop and implement reforms within
an agreed timeframe and provide any further resources to the Prostheses List
Advisory Committee and the Department of Health that are required to achieve
this.
Recommendation 5
5.8 The committee recommends that the Prostheses
List Advisory Committee continue to consult with stakeholders regarding reform
of the Prostheses List to ensure transparency of the reform process.
Recommendation 6
5.11 The committee recommends that where the
Commonwealth decides that a prostheses registry is needed, the Parliament
should ensure that the registry is legislated for and collection of data is
made compulsory.
Recommendation 7
5.14 The committee recommends that the Government
legislate for the compulsory provision of private hospital and day surgery data
to the Independent Hospital Pricing Authority.
Recommendation 8
5.18 The committee recommends that action is needed
to reduce the prostheses costs and that savings should be delivered as soon as
possible and have an evidence base.
Recommendation 9
5.19 The committee recommends that guidelines for
targeted prostheses reviews be finalised at the earliest opportunity and
published with a schedule of proposed targeted reviews to enable stakeholders
sufficient time to prepare for the reviews.
Recommendation 10
5.26 The committee recommends that the Department
of Health undertake further analysis and consultation, including with
consumers, to determine the most appropriate benefit setting model or models,
and that this analysis include investigation of the introduction of outcomes
based categorisation of items on the Prostheses List, and the option of the
government purchasing devices directly.
Recommendation 11
5.27 The committee recommends that the Prostheses
List Advisory Committee be required to review the group prices for prostheses
when applications for new comparable devices are received which request listing
at a lower price than the existing benefit level for that group of devices.
Recommendation 12
5.28 The committee recommends that the Minister for
Health release new Independent Hospital Pricing Authority data on the
differences between prostheses prices in private and public hospitals and
investigate whether this could be used to adjust Prostheses List Advisory
Committee prostheses prices as soon as possible.
Recommendation 13
5.29 The committee recommends that the Prostheses
List Advisory Committee further investigate rationalisation of the Prostheses
List to reduce its size as an important element in reviewing and reforming the
benefit setting process.
Recommendation 14
5.30 The committee recommends that the department
investigate the impact of the 25 per cent market share requirement and its role
in distorting the market.
Recommendation 15
5.32 The committee recommends that the Prostheses
List Advisory Committee investigate a mechanism for the reimbursement of
medical devices not currently eligible for inclusion on the Prostheses List,
including non-implantable devices and implantable devices not requiring
hospital admission.
Recommendation 16
5.35 The committee recommends that the nature and
cost of services associated with a medical device on the Prostheses List be
disclosed separately to the cost of the device.
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