MSAC to review funding gaps blocking access to cardiac ablation in private hospitals

Persistent advocacy by patient groups has prompted the Medical Services Advisory Committee (MSAC) to review the funding gaps for pulsed field ablation (PFA), a move that will improve patient access to atrial fibrillation (AF) treatment in private hospitals.

AF, the most common cardiac arrhythmia, affects around 500,000 Australians and is associated with an increased risk of heart failure, stroke and death, contributing to more than 200,000 hospital admissions each year.

MSAC oversees Medicare Benefits Schedule (MBS) funding for cardiac ablation procedures. While PFA is currently billed under existing MBS item numbers developed for older radiofrequency and cryoablation technologies, stakeholders argue the reimbursement does not reflects the full cost of delivering the newer technology in private hospitals.

Hearts4heart has been a leading advocate for reform, highlighting the key barriers preventing equitable access to PFA and urging MSAC to review the funding mechanism for privately insured patients.

Access to PFA differs markedly between the public and private healthcare systems. In public hospitals, patients often face waiting times of one to two years for AF procedures. In the private sector, the financial shortfall associated with delivering PFA restricts the number of procedures hospitals are able to provide or leaves insured patients and private hospitals facing the burden of absorbing the cost gap.

“The private health insurance we have been led to believe we must have and pay so dearly for, if we want the very best care and the latest medical technology, is another well fabricated mistruth. Until a patient’s life means more than just a number and profit, nothing will ever change,” said a patient who requested anonymity. He said a catastrophic cardiac event had shattered what he described as his “naïve” understanding of the health system.

Beyond conventional radiofrequency and cryoablation, PFA represents a significant technological advance in the treatment of AF. Its high tissue selectivity, minimal thermal energy, rapid energy delivery and controlled tissue injury enable efficient myocardial ablation while reducing the risk of complications, including pulmonary vein stenosis and damage to surrounding structures.

The Australian market for PFA technologies is becoming increasingly competitive. Johnson & Johnson MedTech launched its Varipulse system last year, joining Boston Scientific’s Farapulse and Medtronic’s Pulseselect systems.

Efforts to improve evidence generation are also advancing. Australia’s first Atrial Fibrillation Ablation Registry (AuRA-AF) officially commenced in mid-2025. Supported by a $7 million grant through the Medical Research Future Fund (MRFF), the registry is housed within Monash University’s Centre of Cardiovascular Research and Education in Therapeutics (CCRET). It will monitor the safety, efficacy and equity of AF ablation procedures, with the aim of addressing existing disparities in patient access.

MSAC is now inviting submissions as part of its review, with the consultation expected to inform future funding arrangements for PFA in private hospitals.

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