Department of Health launches consultation on contentious General Use Items

MedTech & Diagnostics News: The Department of Health has launched a six-week consultation to address raised “concerns” regarding the increased utilisation and expenditure of General Use Items (GUIs) on the Prescribed List (formerly Prostheses List).

Intense lobbying from key industry bodies, including the Australian Private Hospitals Association (APHA), Medical Technology Association of Australia (MTAA), Catholic Health Australia, and the Australian Medical Association (AMA), was instrumental in Federal Health Minister Mark Butler’s May decision to maintain funding for GUIs under the Prescribed List.

The potential removal of approximately 500 GUIs from the Prescribed List would have had serious repercussions for patient care, particularly affecting surgeries predominantly performed on women, such as breast cancer procedures, caesarean births, and bariatric surgeries. Regional hospitals, operating on thin margins, would have been among the hardest hit.

“Following the [Health Minister’s] announcement, concerns were raised by some stakeholders about the increasing growth in the use of GUI per episode of care, and the resulting increase in expenditure for these items,” the Department of Health stated in its consultation communication.

The consultation aims to identify ways in which the “concerns”, predominately raised by private health insurers, may be addressed, “particularly improving the integrity of PL settings in the context of GUI and managing the increase in GUI utilisation and subsequent growth in expenditure.”

Professor Mark Frydenberg, Chair of the Health Policy and Advocacy Committee at the Royal Australasian College of Surgeons (RACS), highlighted in the submission to Prostheses List Reforms – Bundling of Benefits for General Use Items.

“An appropriate reform would be to increase clinicians’ focus on choosing wisely in relation to such items, and prosthetic devices more generally.

“In principle, RACS would be willing to work with regulators to educate surgeons and other clinicians about best practices in the use of such items and even provide opinions about different General Use Items and other disposables and prosthetics,” he said.

The Independent Hospital Pricing Authority (IHPA) collected data on usage of GUIs for private patients in the public sector, which may provide some insights. If public sector references are used for pricing, then public sector references may also be used for volume.

The Department of Health acknowledged that “any measures implemented could have an impact on different stakeholders’ groups”.

The consultation is set to close on 20 September.

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