Australian Private Insurance Reforms could Impact Medical Device Reimbursements

The Australian Department of Health has started consultations on how to improve the country’s private health insurance system that may affect how implantable medical devices are reimbursed once any potential reforms are implemented.

Australia  private insurance system reforms and implantable medical device reimbursementAccording to the health department’s consultation announcement, Australia’s private health insurance system is under strain due to multiple factors such as rising chronic disease rates, patient expectations and increasing costs.

Any reforms to the private insurance system, however, will likely impact how some medical device manufacturers are reimbursed. So argues Mike Skalsky, managing director of Emergo’s operations in Australia.

In particular, Skalsky notes that Prostheses List arrangements—which include many implantable devices--make up a major component of Australia’s private health insurance system.

“Many of our clients sell principally to the private hospital market or rely on revenue generated in the private system to maintain a profitable business in Australia,” Skalsky says. “Any substantive changes to the Prostheses List arrangements, be they administrative, financial or in terms of eligibility criteria, may have an impact on how implants are reimbursed down the track.”

Emergo will monitor the government’s consultations with industry and consumer groups and report back on any additional details in terms of how Australian market registrants may be affected.

Additional Emergo resources available on the Australian medical device regulatory system include our regulatory process chart and a four-minute video overview of the country's device approval process.

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