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Aussies Called to MedTech Innovator Competition

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[vc_row][vc_column][vc_column_text]Australian start-ups are being encouraged to apply for the MedTech Innovator’s four-month Showcase and Accelerator competition, which will feature the healthcare industry’s best-in-class medical technologies from around the world, and the opportunity to be awarded up to $500,000 and in-kind prices during the competition.

In 2018, more than 730 companies applied to participate in the competition, which culminated with a plenary session at The MedTech Conference in Philadelphia, attended by over 3,000 leaders in the MedTech industry. From that, five finalists were selected to compete in the grand finale, in which a live audience voted for the competition winner.

MedTech Innovator CEO, Paul Grand, said the competition “fosters an industry-wide global network that provides immense value to participating start-ups and industry partners who share a mission to improve and extent patients’ lives.”

In 2019, there will be several rounds in which companies gain valuable exposure to industry executives and decision makers through online application reviews, in-person pitch sessions, mentoring, conference showcases, and live competitions. The top applicants, selected by leading MedTech companies, will be invited to present at one of MedTech Innovator’s regional pitch events across the US and international in spring 2019.

There is no application fee, and no equity required from participants – so apply now! [/vc_column_text][/vc_column][/vc_row]

Better Data Demands for Aussies

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[vc_row][vc_column][vc_column_text]A collaboration between the Digital Health Cooperative Research Centre, the Capital Markets CRC and Research Australia, the report – Flying Blind 2:  Australian Researchers and Digital Health – found that better access to health data for researchers could save the economy $3 billion and improve health outcomes for all Australians, over 15 years.

In spite of the abundance of digital data that Australia holds, health and medical researchers are continually forced to assemble data-sets for their research themselves – a process which can take months, if not years. These delays can also drain funding and resources, forcing researchers to abandon linked data studies or seek support from other countries’ data-banks.

The report also told of a University of Melbourne researcher having to pay spend $60,000 of her research funding in order to access Victoria’s registry of births, deaths and marriages. This is made even more absurd when it was discovered that the research was government funded, meaning the funds went from the government to the researchers and back to the government.

Fragmentation of Australian health data also proves immensely troublesome, with various State and Federal laws and regulations creating a maze of bureaucracy researchers must navigate.

The Flying Blind report has proposed a series of recommendations for enhanced medical research in Australia, including the creation of Accredited Release Agencies to build data collections suitable for research, and a single national data-rich access point for researchers. The report also suggests creating publicly accessible protocols for all Australians to see how health data is used and how it is making a difference.[/vc_column_text][/vc_column][/vc_row]

WHAT TO EXPECT IN 2019

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The Federal & NSW Election

The most anticipated event of 2019 will be the Federal Election which will pit Prime Minister Scott Morrison against Opposition Leader Bill Shorten. While the date of the election has still not been officially announced, many political pundits are predicting the Government will go to a May election, giving the Prime Minister time to put forward a Budget in April, with an expected budget surplus.

A May Federal Election would be welcomed news for the NSW Government which is facing an ever-tightening election of its own, due on 23 March. The NSW Coalition Government has experienced a heavy voter backlash recently, attributed to the political instability of their Federal counterparts.[/vc_column_text][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Roll-out of Private Health insurance reforms

The Federal Government’s private health insurance (PHI) reforms, lead by Health Minister Greg Hunt, will be introduced starting from 1 April 2019, with insurers having until 1 April 2020 to fully adopt the changes.

The reforms are aimed at simplifying hospital products for consumers by creating four easily understood tiers – Gold, Silver Bronze and Basic. The Government believes the new tiers will give consumers greater certainty about the services covered by each type of hospital treatment product.[/vc_column_text][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Labor’s Productivity Commission

In February 2018, Opposition Leader Bill Shorten and Shadow Health Minister Catherine King, announced the Opposition’s policy to cap PHI premium increases at two per cent for two years and task the Productivity Commission with a comprehensive inquiry into the private health sector.

The Opposition believes government has a greater role to play in restoring affordability and value for consumers, and stopping the private health insurance exodus that is putting the system at risk. At the end of 2018, the Opposition released its own issues paper to kick-start their consultation with industry stakeholders , and invited submissions to help inform the design of their pledged Productivity Commission inquiry.

It is expected the promised inquiry would run for approximately a year.[/vc_column_text][/vc_column][/vc_row]

THE FIVE FACTORS OF PRICE – APPLES & ORANGES

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[vc_row][vc_column][vc_column_text]Like any product or service, the price for medical devices will vary from one country to another. For example, the price of a Toyota Sedan in Australia is going to be different from the price for the same Toyota Sedan in the United States or Europe due to a range of factors.

So why is this so for medical devices? Well let’s look at the top five factors influencing price:

  1. DIFFERENT HEALTHCARE SYSTEMS

The differences between healthcare systems from country to country, including different political, policy and economic drivers, has a significant impact on the price of devices. Countries, such the UK and Canada, that appear to have comparable healthcare systems to Australia are, when analysed in greater depth, actually quite different.

Let’s take Canada for example. Based on the OECD health expenditure statics (including PHI as a percentage of total healthcare expenditure and the proportion of population covered by PHI), Canada appears to have a similar healthcare structure to Australia’s. However, unlike in Australia, Canada does not have a private market for prostheses due to the fact it does not allow private health insurers to cover services provided by Canada’s public healthcare system, including hospital procedures that include prostheses.

In contrast, Australia’s healthcare system does allow for this, meaning there is a private and a public market for prostheses.

 PURCHASING ARRANGEMENTS AND MARKET SEGMENTATION DIFFERENCES

Purchasing arrangements for medical devices also vary from country to country. The greater a country’s level of market integration, the greater the capacity they will have to purchase devices at lower prices through improved economies of scale and market volume guarantees for MedTech companies.

For example, in Sweden, there is negligible PHI coverage of the population due to the fact Sweden’s healthcare system is integrated to a high degree with county councils being responsible for both the financing and organisation of healthcare services. Counties also own and operate most of the country’s hospitals. With a healthcare system that is essentially 100% publicly owned and operated, Sweden is able to centrally purchase prostheses through a small number of entities.

  1. DIFFERENCES IN VOLUME, MEDICAL PRACTICE AND PATIENT NEED

Some countries undertake certain procedures using medical devices more frequently than others. For example, according to the OECD Health at a Glance 2013, Germany conducts almost twice as many coronary angioplasty procedures per 100,000 compared to Australia – not to mention Germany’s population is four times that of Australia’s. This means the significantly greater volume of devices associated with coronary angioplasty procedures being required in Germany, compared to here in Australia, results in lower prices of those prostheses for Germans.

  1. DIFFERENCES IN ECONOMIES & GEOGRAPHY

Local economic costs can also add to the price difference for medical devices from country to country. Local costs in Australia such as wages, transportation costs (petrol, airfares), facility costs (coupled with the higher need for warehousing in Australia), currency fluctuation and exchange rates can all influence the price of devices.

Geographical considerations can also influence the price of medical devices. Australia’s isolated location, its low population density and vast land mass have a significant impact on the cost of importing devices and distributing them across Australia.

  1. LEVEL OF INDUSTRY SUPPORT SERVICES

The level of service required from a MedTech company can vary from country to country, and from one prosthesis category to the next. This can impact on the price attributed to a particular prosthesis.

For example, in some European countries, companies do not provide post-procedure follow-up technical support services for certain device types. Funding for these services is allocated to clinicians in the hospital with support from highly trained staff. Therefore, these services are provided with little support from MedTech companies. This is also the case in the Australian public healthcare system.

In contrast, the private markets in Australia, United States and in Japan for example, have a high demand for MedTech companies to provide support services. In Australia, the cost of this support over the life-time of a device is factored into the prosthesis’ benefit.[/vc_column_text][/vc_column][/vc_row]

More Than $500 Million Research Boost To Improve Lives

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[vc_row][vc_column][vc_column_text]A total of 682 grants will be funded, totalling more than $526 million, through the National Health and Medical Research Council (NHMRC).

The funding announced today includes:

    • $61 million for cardiovascular disease research
    • $86 million for cancer research, including cancers where treatment options are limited and early detection is critical
    • $41 million for mental health research projects
    • $29 million for diabetes research
    • $28 million for obesity research
    • $25 million for research focused primarily on improving the health of Indigenous Australians

As the highest recipient of funding of any university or institute, Monash University will receive almost $76 million to support excellent medical research.

The funding includes over $5 million to a team lead by Professor Sophia Zoungas of Monash University for her important cardiovascular disease research.

Professor Zoungas and her team will lead a trial to understand whether statins prolong independent living and reduce cardiovascular events in older adults without established vascular disease or diabetes.

This impressive research project is only one of 682 projects that will continue the proud Australian tradition of ground-breaking discovery and translation into better health for all.

This funding will ensure sustained support for our internationally-competitive health and medical research sector.

Projects announced today support cutting edge ideas from researchers at all careers stages and included research on vaccine development and tackling antimicrobial resistance.

These grants will support our health and medical research workforce, providing greater opportunities for more life-changing medical breakthroughs.

Health and medical research is one of the four pillars of the Government’s Long-Term National Health Plan. Our Government is committed to strengthening health and medical research.

The 2018–19 Budget we provided a record total of $6 billion to Australia’s health and medical research sector, including $1.3 billion for a health and medical industry growth plan to drive a new era of better health care and fuel jobs and growth.

A full list of grant recipients is available on NHMRC’s website[/vc_column_text][/vc_column][/vc_row]

BACK TO SCHOOL FOR EDWARDS LIFESCIENCES WITH A HELPING HAND

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[vc_row][vc_column][vc_column_text]Wairoa School provides a comprehensive education for children aged 5 to 18 years of age who have moderate to severe disabilities and may also have additional support needs related to autism, physical and sensory disabilities.

The Edwards’ team arrived before school started and once they had hats, sunscreen and gloves in place they got straight into it.

This isn’t the first time Edwards employees have done voluntary work at the school. Last year, over two days, a collective total of 78 hours was volunteered by staff to action the garden vision of the school side entry grounds.

Edwards says it aspires to have 100% of their employees do at least one charitable activity every year.

Employees completed the new garden with a feeling they really contributed and made a positive impact in the lives of the kids and their families.

Managing Director of Edwards Lifesciences ANZ, Pat Williams said “the physically demanding work our volunteers did over Friday and Saturday at Wairoa School for the severely handicapped was truly phenomenal – I’m confident that the staff and students will appreciate the work to improve this area of the school.

“Our commitment to charitable giving is one of the defining elements of our culture. We’re fortunate to be able to support many health- and community-focused programs through grants to non-profit organisations around the world from the Edwards Lifesciences Foundation.”

This year the Wairoa School was successful recipient of $5,000 from the Edwards Lifesciences Foundation.

Edwards believes that through their actions they will become trusted partners with customers, colleagues, and patients – creating a community unified in its mission to improve the quality of life around the world.[/vc_column_text][vc_images_carousel images=”2640,2641,2642,2643″ img_size=”large” speed=”10000″][/vc_column][/vc_row]

PRICE DISPARITY BLAMED FOR HIGHER PREMIUMS

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[vc_row][vc_column][vc_column_text]Just last month, the Guardian reported that the Australian competition watchdog’s review of the private health insurance industry found Australians were forced to cough up $23.9 billion in premiums last financial year – that’s $834 million more than they had to pay in 2016/17.

The Guardian also reported that “the number of people with hospital-only or combined health cover fell 0.9 percentage points to 45.1%, while the proposition of policyholders with extras-only cover rose to 9.2% from 8.9%”.

The association representing Australia’s private health insurance industry, Private Healthcare Australia (PHA), has continued to assert that private health funds are delivering record health benefits for Australians, despite their decision to increase premiums for their customers.

PHA has points to a number of factors for the price hikes, including blaming medical technology (MedTech) innovators for the prices they charge for medical devices. However, PHA appears to have conveniently ignored the Agreement MedTech innovators reached with the Commonwealth Government to deliver $1.1 billion in savings, over four years. This enabled MedTech innovators to singlehandedly deliver, for Australians, the lowest increase to their private health insurance premiums in 17 years.

Another tried and tested argument rolled out by the PHI industry is that Australians are charged up to three times more for medical devices than their British and New Zealand counterparts. MedTech innovators, however, argue that the variations in prices for medical devices reflects the differing market environments, supply chains, economies of scale and contrasting reimbursement systems from country to country.

So do Australians really pay more for the same devices? Let’s take a look:

In 2016, one of Australia’s largest PHI companies, Bupa, acknowledged the difficulty in comparing the prices of devices in one country to another. When asked why Australians are having to pay up to $400 more a month for private health insurance than consumers in countries like Britain, Bupa said the “private health market in Britain was ‘very different’ (than Australia’s market), with insurers able to pick and choose customers and force patients to seek their approval before being referred to a specialist.”

The structure of healthcare systems in individual countries, the split between private and public healthcare and the source of funding impacts the price of prostheses, making it impossible for prices to be the same across different countries.

A simple example of these difference can be found when comparing the incentives for the public hospital sector and the private hospital sector and the services they provide. Public hospitals are incentivised to provide necessary and efficient care at the lowest possible cost through, what is called, Activity Based Funding (ABF). As a result, purchasing of prostheses occurs through centralised tenders which trade off prostheses choice against prostheses volume (either directly or indirectly), with control about what is available to the hospital being made by hospital administrators.

The private hospital sector, however, is not constrained by ABF and clinicians rather than hospital administrators make the decisions about services and care provided, including the types of prostheses they would like to use. These different incentives influence the different patterns of use and the economies of scale that are possible.

So, while some countries may appear to have comparable healthcare systems to Australia, but when they are analysed in a greater depth, they can actually be completely different.[/vc_column_text][/vc_column][/vc_row]

$240 MILLION FOR RESEARCH INTO THE NEXT BIG MEDICAL BREAKTHROUGH

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[vc_row][vc_column][vc_column_text]Applications for the Frontier Health and Medical Research program have now opened, allowing researchers to push the boundaries to develop tomorrow’s health and medical breakthroughs.

The Frontiers program is filling a gap in the research sector by providing government funding for early innovative projects and ideas that traditionally would not have received funding at this stage.

The Australian-first program has a unique, two-stage structure and was developed in consultation with Australian and international leaders in health and medical research including Research Australia.

In stage one, up to ten selected applicants will receive funding of up to $1 million each over one year to develop detailed planning for their cutting-edge research projects.

In stage two, a number of research plans developed under stage one will be chosen to receive funding to develop their ideas into new technological advances or approaches to revolutionise healthcare.

Stage two grants could be $50 million or more depending on the project and can extend over five years.

This program will confirm Australia as a leading source of innovation and discovery and will help bring about the next big medical breakthrough.

Frontiers is an initiative under the $1.3 billion National Health and Medical Industry Growth Plan, announced in the 2018 Budget. This game changing program is funded by the Government’s Medical Research Future Fund (MRFF).

Minister Hunt said the investment has the potential to transform healthcare and stimulate growth in the Australian medical technologies, biomedical and pharmaceutical (MTP) sector, a vital part of the innovation economy.

“The Government is able to provide unprecedented levels of support to health and medical research because of our strong economic management,” Mr Hunt said.

The MRFF is an endowment fund, which will mature at $20 billion, providing a sustainable source of funding for vital medical research. It is the single largest boost in health and medical research funding in Australia’s history.[/vc_column_text][/vc_column][/vc_row]

KENEALLY’S STILLBIRTH STORY BRINGS TEARS

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[vc_row][vc_column][vc_column_text]Senator and former NSW Premier Kristina Keneally has been a strong advocate for removing the stigma around stillbirth, having paid tribute to her stillborn daughter, Caroline, in her maiden speech before the Senate earlier this year. Senator Kenneally, who had been a driving force behind the inquiry, was given another opportunity to discuss the issue this week in the Senate as the Select Committee on Stillbirth Research and Education tabled its long-awaited report. Most significantly, the report brought to light the reality that six babies are stillborn daily in Australia. According to Senator Kenneally, part of the high rate has been an apprehension on the part of the public to discuss and share their experiences and insights of a particularly traumatic event in the life of parents and families. In Senator Kenneally’s words: “we have considered stillbirth too sad to talk about.”

When the report was handed down in the Senate, Senator Keneally was moved to tears as it became apparent that stillbirth was now part of a conversation leading to better health outcomes, better emotional support and better community awareness. She took the moment to recognise the names of the children who had been lost and the bravery of their parents who had shared their personal experience of stillbirth with the inquiry. Poignantly, Senator Keneally highlighted that the report would be “part of their legacy”. In tabling the report, Northern Territory Senator Malarndirri McCarthy also took the opportunity to acknowledge the work of Senator Keneally in bringing the issue to the public’s attention.

The report found that 1 in every 137 women who reached 20 weeks of pregnancy would experience a stillbirth, a striking figure that Senator Kenneally argued was “significantly higher than in similar nations such as New Zealand, the UK, the Netherlands and the Scandinavian countries.” In fact, the Australian rate of stillbirths is more than a third higher than other OECD countries with the best birth outcomes.

Following an eight-month investigation, 268 submissions and six public hearings, the inquiry also heard about the trauma that continues outside of the hospital – with stories of women being made redundant from their jobs and other parents being told they were no longer entitled to paid parental leave.

The report made recommendations in three key areas: prevention, investigation and support. Critical activities in these areas will involve national education campaigns, continuity of care models, training for clinicians, changes to parental leave schemes and further investigation into stillbirths at the postmortem stage.

Health Minister the Hon Greg Hunt MP responded to the report with the announcement of a national roundtable – as well as an initial commitments of $7 million to medical research and education programs.[/vc_column_text][/vc_column][/vc_row]

A Finite Resource With Infinite Demands

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[vc_row][vc_column][vc_column_text]The Medical Services Advisory Committee (MSAC) plays an important role in determining which medical services Australians have access to through Medicare.  It may be stating the obvious, but funding for healthcare is a finite resource, and there are infinite demands for healthcare.  It follows that healthcare dollars must be spent judiciously.

MSAC is charged with deciding whether a new medical service should be publicly funded based on an ‘assessment of its comparative safety, clinical effectiveness, cost-effectiveness and total cost’.  Innovations in medical technology often require the development of new medical procedures to ensure that the technology can be utilised for its best possible performance.  MSAC decides whether a medical professional can be paid for performing the procedure. If the application is successful, the procedure will be included on the Medical Benefits Schedule (MBS). If the technology is implantable then the device will likely to be eligible to be included on the Prostheses List.

Some new technologies allow patients to be treated outside of a hospital.  Treatment for varicose veins has previously involved invasive procedures to be carried out solely in the care of hospitals.  Innovation in technologies such as radio-frequency ablation hasenabled patients to access these procedures in alternative, more office based environments.  The MBS covers payment to the doctor for performing the procedure but does not, in most cases, make an allowance for any single-use technologies.  This can result in significant out of pockets for patients.  MSAC has acknowledged this structural issue on a number of occasions in their assessments of new technologies.

This problem is compounded by our strange system of private health insurance (PHI). PHI covers hospital admissions but does not cover office-based therapies, therefore hospital-based treatments may be less expensive for patients, while overall costing more.  Looking at this from an economic perspective, we can see that the least costly options of out-patient based innovations are not being incentivised by the payment system.

There is certainly an opportunity for Government to have a more flexible approach to what may be included in an MBS fee. Realistic coverage for the actual cost of delivering a service, including device cost, would be of real benefit to patients and is likely to reduce the cost to the health system overall.  Alternatively, at a time when the value of PHI is certainly being questioned, mechanisms whereby PHI could cover out of hospital procedures – that the MSAC has previously considered to represent good value, should also be considered.[/vc_column_text][vc_zigzag][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_single_image image=”2606″ img_size=”full”][/vc_column][vc_column width=”3/4″][vc_column_text]

About The Author

Sarah Griffin B.App.Sc (Physio), GradDIp Health Ec & Policy
Principal Medtechnique Consulting.

Sarah Griffin is the founder of Medtechnique Consulting and has more than 25 years experience in medical technology, both in Australia and the United States. Sarah expertise includes health economics, health insurance, health policy and legislation, reimbursement systems and government relations. Sarah also serves as Chair of the AusMedtech Health Economics Expert Panel and as an independent expert to the Australian Government’s Industry Working Group on Prostheses List Benefit Reform.[/vc_column_text][/vc_column][/vc_row]