LIST OF RECOMMENDATIONS

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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