Prosthesis List Reform

Medical device prices in Australia are the highest in the world, increasing health insurance premiums for 13 million Australians.

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 $1000s of dollars less.

The Federal Government must reform the Prostheses List by January 2022.

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 fours years, shared between consumers and hospitals.

Myth vs Fact

Medical device prices in Australia are the highest in the world. Big MedTech multinationals are trying to protect their profits and prevent Prosthesis 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 Prosthesis List reform, passing on any savings to consumers as premium reductions.