Triage
An Applicant seeking public funding for a medical service or an amendment to an existing service provides a completed comprehensive application form and preliminary information to the medical services Health Technology Assessment (HTA) Team in the Department of Health.The Department will assess the application to determine its suitability to proceed through the Medical Services Advisory Committee (MSAC) process.
Pathway
MSAC is supported by two sub-committees:There are three pathway types:
This is the primary pathway in which the majority of applications will progress through the MSAC process. This pathway will generally involve the development of a PICO Confirmation by a HTA Group; consideration at one PASC meeting; and the development of an Assessment Report for consideration by ESC and MSAC. Comprehensive
The comprehensive pathway will follow the same steps as a Standard pathway but will require more than one consideration by PASC and have a formal consultation period between the two PASC meetings. Expedited
If an applicant’s PICO is very clear in the application form stage, the Department and the MSAC Executive may agree that the application can bypass PASC and progress straight to the development of an Assessment report.In consultation with the Applicant, the Department will decide on the most appropriate pathway for each application to progress through the MSAC process.
Consultation
Targeted public consultation will occur on the Application Form after suitability of the proposed medical service is determined. Relevant material will be redacted by the Applicant if requested.Informal public consultation will occur after suitability of the proposed medical service and continue throughout the application’s MSAC process. The Application Form will be uploaded to the MSAC website and remain on the individual application webpage in order to provide the stakeholders, competitors, consumers and interested parties the opportunity to comment at any time.
The Department will accept all comments on an application and provide them to the Applicant, Assessment Group and MSAC and its sub-committees.
PICO Confirmation
A Standard or Comprehensive Application will have the PICO confirmation (formally known as the Protocol) developed by a designated HTA group with expertise in HTA contracted by the Department (with input from the Applicant), then considered and ratified by PASC.Application Assessment
The Applicant or the contracted HTA group presents the evidence that comprises of clinical literature and an economic evaluation that supports the Application, as outlined in the PICO confirmation, and is presented in the form of an Assessment Report. The Assessment Report is critiqued by an independent HTA group and then considered by ESC.If the Applicant needs MSAC assurance that the clinical claim is correct before investing extensively in an economic evaluation, an optional two stage Assessment Report is available.
MSAC Appraisal
MSAC undertakes a rigorous and transparent appraisal of the evidence presented to them by ESC before advice is provided to Government for consideration. This ensures that Government supports cost effective, evidence-based, best practice care.A Public Summary Document, that incorporates meeting outcomes, is published online and MSAC’s advice to Government is provided for each item.
Withdrawal
An applicant may request that its application to MSAC be withdrawn at any time.Applicants should note that where MSAC has completed its considerations of an application and the applicant seeks to withdraw that application:
Post MSAC Consideration for Listing
Only after Government consideration of advice from MSAC is a decision made on whether an item is to be included or amended on the MBS.MSAC is a non-legislative committee, and so its advice is not binding. The Minister for Health will decide whether MBS funding will be granted.