Assessment of new health technologies 2019–20

Closed 4 Oct 2019

Opened 4 Sep 2019

Contact

enquiries.ihacpa@ihacpa.gov.au

Overview

IHPA's core function is the pricing of public hospital services. IHPA’s Pricing Guidelines recognise that the "pricing of public hospital services should respond in a timely way to the introduction of evidence-based, effective new health technology and innovations in models of care that improve patient outcomes."

Accounting for new health technologies

While IHPA was not established to take on a major technology evaluation role, it does partially account for the adoption of new health technologies through its indexation methodology which projects three year old data to the year of the National Efficient Price. The indexation rate reflects the average increase in cost over the previous five years.

IHPA also accounts for new health technologies when updating the Activity Based Funding classification systems. For example, IHPA updates the Australian Refined Diagnosis Related Groups (AR-DRG) classification to ensure it reflects current clinical practice and models of care.

IHPA seeks input from specialist health organisations such as the Health Technology Reference Group and the Medical Services Advisory Committee.

Impact of New Health Technology Framework

IHPA has developed the Impact of New Health Technology Framework (the Framework) as an additional process for the review of new health technologies.

Under the Framework, IHPA, through its Clinical Advisory Committee (CAC), monitors and reviews new health technologies to determine whether they are adequately accounted for in the pricing of public hospital services. Where the technology is not accounted for, IHPA may refer the technology for priority coding and classification development.

This annual process involves IHPA, the CAC and state and territory health departments reviewing reports on new health technologies provided by government advisory groups and other interested stakeholders, such as health technology companies.

A new health technology will be referred for priority classification and coding development where it can be demonstrated that:

  • the technology is in use in Australian public hospitals or its future uptake is expected to be substantial enough to warrant classification or coding development
  • the difference between the price weight for the most frequently mapped Diagnosis Related Group (DRG) and the technology's cost estimate is significant
  • the total cost of the mapped DRGs and the number of patients is material
  • the technology can be better accounted for through classification and coding development (that is, the technology should not be a diagnostic test or pharmaceutical).

Assessment of new health technologies for 2019–20

IHPA sought submissions from interested parties as part of its 2019–20 review of new health technologies under the Framework.

The submission period ended on Friday 4 October 2019.

IHPA’s final assessment of the technologies to refer for classification and coding development will be completed by May 2020. IHPA will advise applicants on the outcome of its assessment.

As part of the 2019–20 assessment process IHPA considered the following technologies, none of which were shortlisted for priority classification and coding development:

Name of technology Assessment
Substitution of 68Ga-DOTA-peptide PET/CT scanning in lieu of Octreotide for patients undergoing somatostatin receptor diagnostic imaging Included in the Australian Classification of Health Interventions and generally captured by the Medicare Benefits Schedule
Extended half-life blood clotting factors VIII and IX Generally not coded and does not affect Diagnosis Related Groups
Cardiac ablation for atrial fibrillation Accounted for in the classification system
Peritoneal dialysis with two-way remote monitoring system Generally not captured separately as an intervention in the admitted or non-admitted classifications
Endovascular clot retrieval Captured in the classification system. IHPA is reviewing them as part of the work program on the Australian Refined Diagnosis Related Groups classification system.
Neorostimulator devices
Implantable spinal infusion devices

Audiences

  • Health professional/clinician work for a Primary Health Network (PHN)
  • Health professional/clinician work for a Local Health Network (LHN) or public hospital
  • Government
  • Research institute, organisation, university, policy institute or consulting group

Interests

  • Other