Assessment of New Health Technologies
Date published: 28 July 2023
The Independent Health and Aged Care Pricing Authority (IHACPA) recognises the need for the pricing of public hospital services to respond in a timely manner to the introduction of new health technologies and innovations in models of care.
IHACPA, in consultation with its advisory committees and classification working groups, will assess new health technologies for incorporation into the activity based funding classifications where they are not adequately accounted for in the pricing of public hospital services, based on submissions received from jurisdictions, advisory bodies and other stakeholders.
Submissions for new health technologies
Under the New Health Technology Policy, IHACPA will accept submissions for new health technologies on an ongoing basis, to support the timely incorporation of new health technologies into the national pricing model.
Submissions for new health technologies can be made through the IHACPA Australian Classification Exchange by registered users. Prior to making a submission, submitters should ensure that they have reviewed the current editions and versions of the classifications on the IHACPA website to determine whether the new health technology is already accounted for with an existing code or class.
Once a submission has been received, IHACPA will undertake a process to review the submission in consultation with its clinical and jurisdictional advisory committees and working groups. This will inform whether the new health technology will be referred for classification development. IHACPA will advise submitters on the outcome of its assessment.
Further information on the submission process is available below:
- New Health Technology Policy
- New Health Technology Submission Guidelines
- Submission form – New Health Technology Policy
Information on previous submissions for new health technologies is available on the IHACPA website and outlined below.
| Submission year | New health technology submission | Assessment | Outcome |
|---|---|---|---|
| 2021–22 | Rapid whole genome sequencing for critically ill paediatric patients | Rapid whole genome sequencing provides an opportunity for less invasive testing of paediatric patients in the intensive care unit setting and more guidance on managing their conditions for their families and the treating teams. Shortlisted for classification development. | Progressed for classification refinement in the Tier 2 Non-Admitted Services Classification as part of updates for Version 8.0 to improve pricing and funding, particularly for familial testing in the non-admitted setting. |
| 2020–21 | Transperineal biopsy | Transrectal and transperineal biopsies are currently classified to the same code and there could potentially be a material/cost benefit to be gained from differentiating the procedures. Shortlisted for classification development. | Classifiable under ACHI Twelfth Edition, implemented from 1 July 2022. |
| Luxturna for inherited retinal diseases | The Australian Classification of Health Interventions (ACHI) does not have specific codes for gene therapy. Shortlisted for classification development. | Classifiable under ACHI Twelfth Edition, implemented from 1 July 2022. | |
| Roctavian for haemophilia A | ACHI does not have specific codes for gene therapy. Shortlisted for classification development. | Classifiable under ACHI Twelfth Edition, implemented from 1 July 2022. | |
| Qarziba for paediatric neuroblastoma | Although antineoplastic agent administration is already accounted for in ACHI, it is not to the granularity of drug class. Shortlisted for classification development. | Considered for classification development, however did not proceed as this intervention is already sufficiently classifiable for the purposes of ACHI. | |
| Zolgensma for spinal muscular atrophy | ACHI does not have specific codes for gene therapy however this technology has already been assessed by the Pharmaceutical Benefits Advisory Committee for listing on the Pharmaceutical Benefits Scheme. Not progressed for classification development. | Classifiable under ACHI Twelfth Edition, implemented from 1 July 2022. | |
| 2019–20 | Substitution of 68Ga-DOTA-peptide PET/CT scanning in lieu of Octreotide for patients undergoing somatostatin receptor diagnostic imaging | Able to be classified in ACHI, although not routinely coded in admitted care, and generally captured by the Medicare Benefits Schedule. Not progressed for classification development. | N/A |
| Extended half-life blood clotting factors VIII and IX | Administration of blood clotting factors is classifiable in ACHI; however it does not inform the Australian Refined Diagnosis Related Groups (AR-DRG) classification. Not progressed for classification development. | N/A | |
| Cardiac ablation for atrial fibrillation | Already accounted for in the classification system. Not progressed for classification development. | N/A | |
| Peritoneal dialysis with two-way remote monitoring system | Intervention is classifiable in ACHI, however ACHI does not distinguish interventions to this level of granularity. Not progressed for classification development. | N/A | |
| Endovascular clot retrieval | Captured in the classification system. Reviewed as part of the work program on the AR-DRG classification system. | A new Adjacent Diagnosis Related Group for this intervention was implemented as part of AR-DRG Version 11.0. | |
| Neurostimulator devices | N/A |
If you have any questions about the New Health Technology Policy or require assistance with the submission process, please contact IHACPA via email at enquiries.ihacpa@ihacpa.gov.au or by phone at +61 2 8215 1100.