Prostheses List Reform

Australians deserve a fair deal on medical devices

The cost of medical devices is one of the largest drivers of premium increases. Currently, the price of medical devices in Australia is around 30% higher than in countries such as New Zealand, France and the UK.

For example, the same stem item used in hip replacements costs more than $4,000 in Australia, while in New Zealand and the UK it costs just $1,800. Australian private health insurers pay up to five times as much for cardiac stents.

The current medical device regime keeps premiums high and ensures that big multinational medical device companies make much larger profits in Australia compared to other countries.

Urgent government reforms to the way medical devices are priced are needed to keep private healthcare affordable for more Australians.

By changing medical device costs, private healthcare premiums will reduce, with no effect on the quality or accessibility of the devices that your doctor can recommend.

The Government must reform medical device pricing

Australians are rightfully proud of our healthcare system. Our doctors and nurses are outstanding and our hospitals are among the best in the world.

But without a strong private healthcare system, our public hospitals would be overwhelmed and could not provide the same level of care to those who need it most.

That’s why it’s so important that the Government does all it can to keep private healthcare affordable.

In Australia, the Federal Government’s Prostheses List set the prices for more than 11,000 items including medical devices like screws and stents used on common surgical procedures like knee and hip replacements.

Private health funds are required to pay a set price for items on the Prostheses List regardless of quality, efficacy, efficiency or safety. The same items in the UK or New Zealand can be $100s or even $1,000s of dollars less.

Australian consumers pay more and medical device companies pocket excessive profits

Private Healthcare Australia has developed a blueprint for reforming prostheses funding in Australia, which redistributes these excessive profits from multinational medical device companies to Australian doctors, Australian hospitals and Australian families. Private health funds have committed to passing on any savings from these reforms to consumers as a reduction in health insurance premiums.

The blueprint proposes:

Moving to bundled payments rather than paying list prices for individual components;
Introducing independent pricing for the bundled payments, with competition between providers; and
Allowing hospitals to negotiate on price to get a better deal.

This plan will save about $500 million over four years, shared between consumers and hospitals.

Myth vs Fact

Medical device prices in Australia are the highest in the world. Multinational medical technology companies are trying to protect their profits and prevent Prostheses List reform.

Let’s look at the facts.

There will be no co-payments. Period.
Doctors and patients will have access to a full range of medical devices. Where patients need more expensive devices, doctors will be able to access more funding through a simple declaration form.
Health funds will not profit from Prostheses List reform, passing on any savings to consumers as premium reductions.