Purpose
The purpose of the Medical Services Advisory Committee (MSAC) Executive is to progress MSAC activity between MSAC meetings and to provide advice to the Department of Health, Disability and Ageing (the department) on Health Technology Assessment (HTA)-related matters.
In supporting MSAC activities, MSAC Executive is also subject to the Terms of Reference of the MSAC, and its subcommittees, the PICO Advisory Subcommittee (PASC) and the Evaluation Subcommittee (ESC).
Roles and function
The MSAC Executive provides advice to the MSAC secretariat, MSAC subcommittees, other HTA committees (such as the Pharmaceutical Benefits Advisory Committee (PBAC)) and other sections of the department on HTA-related matters. MSAC Executive receives input from relevant policy areas for consideration.
MSAC business:
- Progress MSAC business between meetings where required; for example, consider cases where MSAC requested further information to finalise their recommendation.
- Consider improvements to MSAC processes.
- Endorse membership of MSAC subcommittees and ad hoc working groups to facilitate MSAC activities.
- Nominate MSAC representation to external bodies as required and represent MSAC at relevant forums.
- Provide HTA advice to relevant department-led projects.
New or re-submitted MSAC applications:
- Provide advice to inform suitability decisions and on progression through the process.
- Consider requests for advice from other HTA committees on related business (such as co-dependent technologies).
- Provide HTA advice relating to non-Medicare Benefits Schedule (MBS) programs (such as screening, blood product or highly specialised therapy programs) when requested by policy areas or referred by the Minister for Health, Disability and Ageing, including the type and extent of HTA required.
- Endorse changes to MBS items which are the subject of a codependent application with either the Medical Devices and Human Tissue Advisory Committee (MDHTAC) or the PBAC, where there is no need for HTA of the test or device component; for example, when an existing item is suitable but needs reference to a specific drug or device amended.
Existing MBS items:
- Consider matters relating to existing MBS items relevant to the terms of reference of MSAC, or if the MBS Review Advisory Committee (MRAC) or the Minister for Health, Disability and Ageing have referred a matter to the MSAC Executive for HTA advice.
- Provide advice when issues arise with MBS codependency related to a PBS-listed medicine or Prescribed List (PL) medical device.
- Advise the department if proposed MBS item changes are suitable for HTA, and the type of HTA required.
- Endorse changes to MBS items previously considered by MSAC or MSAC Executive, where:
- Changes are required to an item descriptor to correct an unintended consequence of the initial listing, which will change utilisation and therefore the financial impact of the item.
- Changes are required to an item descriptor that will result in greater cost to the MBS, but address an equity or access issue, such as expanding eligibility (not associated with a change in the scheduled fee).
- If none of the above criteria are met, changes to MBS items that are out of scope for MSAC Executive include:
- Changes restricted to the scheduled fee or eligible provider in the absence of any other MBS, PBS or PL listing changes (and so insufficient to trigger an HTA).
- New or changes to existing global consultation items which are typically not amenable to HTA.
Post-implementation review:
- Consider data on predicted versus actual utilisation of MBS items supported by MSAC when review was recommended or is requested by the department.
- Provide advice to modify existing MBS listings based on review, consistent with MSAC advice.
Composition
The department appoints the MSAC Executive which consists of the MSAC Chair, MSAC Deputy Chair(s), and Chairs of the MSAC subcommittees.
MSAC Executive meetings are attended by departmental staff from the MSAC secretariat and from relevant policy areas. When required, the MSAC Executive can extend invitations to others (such as members of other committees, MSAC or subcommittee members with relevant clinical expertise).
Timing and format of meetings
The MSAC Executive meets every 4 to 6 weeks throughout the year, usually via videoconference or teleconference. Occasionally, business may be conducted in-person or out of session via email.
Quorum
The Chair convenes meetings as needed to ensure the MSAC Executive performs its duties effectively.
It is expected that the Chair (or their proxy if appropriate) in consultation with the MSAC secretariat will determine the necessary number of members and advisors or guest discussants to be present at each meeting, to ensure adequate expertise against all agenda items.
Deliverables
The department drafts the minutes for MSAC Executive meetings. The MSAC Executive has input to and approves these minutes.
The Chair and/or MSAC Executive may also prepare and/or sign correspondence, or provide advice on behalf of the MSAC Executive or MSAC, usually responses to requests from stakeholders.
The MSAC Executive has input into the agendas for MSAC meetings.
Reporting
The MSAC Chair reports to each MSAC meeting on activities conducted since the previous meeting and any MSAC Executive decisions taken. MSAC Executive meeting minutes are available to MSAC with the agenda papers for MSAC meetings.
MSAC evaluates MSAC Executive tasks and outputs during meetings, where required.
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