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Funding pathways for new technologies

Recently, the topic of funding pathways for new technologies was discussed as part of a speaker session at the 2015 ARCS Scientific Congress, at Royal Randwick Sydney. Professor Robyn Ward, the current Chairperson of MSAC and a member of the PBAC, provided valuable insight into the known ‘cracks’ in the HTA pathway as four key areas: HTA, funding, implementation and policy.

Of particular interest was the discussion around funding mechanisms and policy frameworks which highlighted the disjoint between the perceived and actual scope of MSAC’s role in the decision process. While MSAC’s role is to advise the Minister for Health on the strength of the evidence in relation to comparative safety, clinical-effectiveness and cost-effectiveness within the context of current funding arrangements, the funding decision is ultimately a matter for Government.

Provided as an example was the April 2014 consideration of gene expression profiling of 21 genes in breast cancer (MSAC application 1342/1342.1). Although MSAC did not support public funding for various reasons, a fundamental issue was identified. The technology (as requested) required the patients sample to be shipped overseas to a laboratory located outside of Australia, however the current legislation under which the MBS operates (Health Insurance Act 1973) requires that all medical services subsidised by the MBS are rendered in Australia.

As the current HTA framework of MSAC accommodates a broad range of technologies, it is not unexpected that submissions and recommendations will at some point challenge the current funding mechanisms and policy frameworks of the Australian health-care system. The question therefore is, how can MSAC help improve health-system efficiencies and better mitigate sponsor, payer and patient expectations of the HTA pathway?

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