RACS on appropriate reform ahead of general use surgical items removal from Prostheses List

MedTech News: The Royal Australasian College of Surgeons (RACS) has been engaging with the Federal Government regarding proposed reforms to the Prostheses List in collaboration with a number of surgical societies. With the first items from the General Miscellaneous Category scheduled for removal from February 2022, RACS plans to continue to engage with the government to advocate for appropriate Prostheses List reforms.

In 2021, RACS and other stakeholders, including the Medical Technology Association of Australia (MTAA), opposed the initial proposal of the Diagnoses Related Group-type (DRG) funding model for the Prostheses List reforms leading the government to eventually decide against pursuing this approach.

Heightened concerns followed the government’s plans to remove many general use surgical items from the General Miscellaneous Category of the Prostheses List.

A consultation paper released in late 2021 stated that such items, ‘would continue to be funded through other mechanisms, such as contracts between insurers and hospitals.’ However, the other mechanisms were not detailed.

RACS provided a response drawing heavily on the views of several surgical societies and associations. “RACS is concerned that where appropriate funding arrangements are not in place clinicians may be put in the position where they must advocate to patients for the use of products which will result in a significant out of pocket cost, instead of a product they believe is inferior, but which is fully funded. It is possible that the private hospital provider may not even give clinicians the choice, and unilaterally make a decision to only stock a product of their choice with the determination based on price rather than in consultation with clinicians regarding needs.”

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The submission from General Surgeons Australia (GSA) noted that many items required for general surgery are bundled under the General Miscellaneous Category on the Prostheses List, most of which have been flagged for removal.

In their submission GSA commented that “removal of these items does not recognise their essential nature in specialised general surgery practice, compromises patient safety, and also means that Specialist General Surgeons would no longer be able to choose the product that is required for particular operations.”

In the event the changes go ahead in February, RACS’ position is that it would be appropriate for access to and use of medical devices removed from the Prostheses List to be independently monitored, with a focus on the views of clinicians. Should monitoring find that clinicians believe their clinical choices have been significantly impacted, then it is RACS’ view that the changes should be revisited.