Health Technology Assessment Review

Report of the Review of HTA

MTAA has welcomed the release of the Report of the Review of Health Technology Assessment (HTA) in Australia by Ministers Roxon and Tanner. The Report provides a framework for a much improved process for the assessment and adoption of rapidly evolving and innovative medical technologies. The recommendations (13 of 16 have been accepted by the Government for immediate implementation) reflect many of the recommendations made by MTAA in its submission to the Review. The Report sets out a vision for the Commonwealth HTA system with the aspiration that Australians have timely, equitable and affordable access to the cost-effective health technologies needed to manage their health.

The recommendations include:

  • Establishment of a policy framework for Commonwealth HTA with shared objectives and principles
  • Establishment of a website for Commonwealth HTA processes that acts as an online resource to assist with navigation of the HTA system and provide regular reports on agreed performance and activity data
  • Improvement in procedural fairness and consistency across all HTA processes including independent review mechanisms, the ability for resubmissions, public disclosure of processes and the adoption of transparent and consistent procedures
  • Adoption of a single entry point to receive applications for subsidy under the MBS, PBS and Prostheses List which will assist in determining the most appropriate committee to appraise the technology. This will become increasingly valuable as the number of hybrid and co-dependent technologies increases
    Capacity for applicants to apply to different HTA processes concurrently
  • Reinforcement of the role of TGA as the authority with sole responsibility for assessing the safety, quality and efficacy of therapeutic products
  • Streamlining of MSAC processes to include assessment of an applicant’s comparative clinical and economic evaluations and establishment of an advisory panel within six weeks of acceptance of an application
  • Review of the terms of reference for the PDC and its subcommittees to ensure that assessments only consider clinical effectiveness
  • Restructure the PDC to improve the balance of membership and include people with expertise in health economics , clinical practice and health policy as well as health consumers, health service providers, and the health insurance and medical technology industries, and an independent chair
  • Significant reform to the PDC processes including acceptance of applications on a continual basis (with a Prostheses List to continue every six months), and abolition of benefit negotiation and setting of maximum benefits. Products will be grouped with products with similar clinical effectiveness at a benchmark price with the capacity for a sponsor to establish superiority of a product compared with those in a group. The mechanisms by which the benefit for a group of products is set, and reviewed, and the premium for a clinically superior product is set, are areas to be further worked through with the Department of Health

  • Consideration of the expansion and use of post market surveillance data including the use of clinical registries.

The Department of Health and Ageing has issued the report on their website.

To view the MTAA media release, please follow this link.

MTAA HTA Review Submission

In December 2008 the Minister for Health and Ageing, Nicola Roxon, and the Minister for Finance and Deregulation, Lindsay Tanner, announced the long-awaited and much-anticipated review of health technology assessment.  The Review provided an opportunity to develop a streamlined process with an accountable and transparent framework for the assessment of medical technologies. 

In its submission, MTAA proposed a structure that ensures the clarification of roles between the regulator (responsible for assessments of safety and efficacy), the HTA body (responsible for a flexible and broad, evidence-based assessment of medical technologies) and the payers, both public and private.

MTAA committed significant resources to the preparation of its submission to the HTA Review, with a weekly meeting of the Access Committee which was the primary vehicle for member consultation and input over several months in the lead up to lodgement of the submission, as well as member forums and the experience of an international reference group of specialists in health technology assessment.  MTAA also retained Access Economics to develop an economic model for its proposed framework.

The Review's brief called for broad engagement, both through the formal channel of a stakeholder reference group, and also through informal channels such as bilateral meetings and focus groups. 

MTAA submissions, a graphic representation of the proposed model and the Access Economics report can be found here.

The Department of Health and Ageing (DoHA) has set up a webpage dedicated to the review that lists more details on the process, submissions, focus group outcomes and discussion papers.

DoHA has now a dedicated HTA website that explains the process and provides more information.