Pathology Technology Australia urges overdue investment as $7B in value lost in healthcare budget

MedTech & Diagnostics News: Over 70% of all medical diagnosis and treatment decisions are underpinned by pathology technology, spanning from cancer to infectious diseases, diabetes to women’s health. Yet, a mere 2% of the total healthcare budget is allocated to pathology testing and technology.

A recent report has brought to light a staggering revelation – over $7 billion in value has been forgone in the healthcare budget due to the inadequate funding of pathology tests and technology.

In anticipation of the upcoming 2024–25 Federal Budget, Pathology Technology Australia is stepping up to address this critical issue, urging the immediate establishment and funding of a “National Diagnostics Strategy and Roadmap (NDSR), guided by a Diagnostics Expert Advisory Group (DEAG) made up of stakeholders from all parts of our healthcare ecosystem, including governments, health professionals, health consumer groups and industry.”

The NDSR will provide guidance for the coordination of diagnostic services in alignment with Australia’s health plans (such as the National Cancer Plan), and horizon scanning for the introduction of new technologies. Furthermore, it seeks to identify high-value, sovereign technology for investment and expedited commercialisation. The DEAG, in turn, will play a pivotal role in recommending the identification and fast-tracking funding of high medical value pathology tests and technology, and advising the government on R&D investments that align with the NDSR.

Advocating for a shift in budget provisions, Pathology Technology Australia proposes an increase in pathology expenditure from 2% to 3% of the total healthcare budget over the next four years. This means a rise from $3.6 billion to $6.7 billion.

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Australia’s healthcare system, largely activity-based, presents challenges in terms of service shortage and inadequate health professionals, particularly in remote/rural regions where healthcare needs are most pronounced. However, innovative technologies such as genomic tests, gene sequencing, proteomic and biomarker tests, point-of-care tests, and clinical decision support software are revolutionising healthcare delivery globally.

The UK’s National Health Services (NHS) sets a benchmark by making medically important genomic tests available within 18 months. In contrast, Australia faces delays of years in having such tests funded through Medicare.

At the recent rare diseases inquiry hearing, Ben Robinson, Head of Access and Innovation at Roche Diagnostics, commented “We’ve seen delays of over eight years to reimburse access to pathology tests. Whilst there are comprehensive genomic tests currently being reimbursed in cancer, due to the way it’s listed, it’s not realistically available to all patients. This is having a direct impact on rare cancer patients and leading to inequitable care.”

He added “There is an opportunity to accelerate the HTA process for all new in vitro diagnostics or pathology tests to 12 months, without compromising patient safety. There’s also an opportunity for reimbursement decisions to factor in a broader range of benefits, which, if included, could support faster decision making.”

The ramifications of delayed access to pathology tests are substantial. As an example, the delay in providing access to NT-proBNP for heart failure has resulted in an estimated loss of $5.9 billion over the past two decades. Similarly, delays in accessing innovative genomic tests have led to a loss of over $529.6 million in value over the past five years.

The curable nature of hepatitis C infection is contingent on early detection. The value of a cure lies in access to the HCV point-of-care test, with the potential to save lives and enhance health outcomes, translating into significant government savings – an estimated $1.9-6.2 million per year.

With over 70% of all medical diagnosis and treatment decisions hinging on pathology tests – and 100% for cancer cases – the cost of testing becomes trivial when considered in the broader context of healthcare expenditure. The time to act is now, to usher in a new era of precision diagnostics and enhanced patient outcomes.

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