Within the Australian dual private/public healthcare system, approval is generally required for a medical therapy or device to be paid for by a third party.
In Australia, physician funding for the performing of procedures occurs through Medicare. Before a device can gain private health reimbursement the associated procedure must have an item number listed on the Medicare Benefits Schedule (MBS). If one does not exist, an application will first need to be made to the Medical Services Advisory Committee (MSAC).
With an MBS item number, companies with implantable devices can apply for inclusion on the Australian Department of Health’s Prosthesis List, which will enable reimbursement for the device in the private healthcare system.
Applications for medical device reimbursement in Australia can be complex and lengthy processes, often requiring input from a team of experts. Our specialist reimbursement consultants can analyse reimbursement opportunities for your technology and develop strategies to maximise successful funding outcomes.
We offer expert reimbursement services, including:
- Analysis of reimbursement opportunities
- Development of strategy to successfully negotiate reimbursement in Australia
- Facilitation of MSAC application teams and preparation of submissions
- Preparation of Prosthetic List submissions
- Advice for clinical trial design to ensure provision of cost efficacy evidence.