Cost-effectiveness should be a critical determinant in whether to fund new cardiovascular devices, according to an article published in the August 6 issue of the Medical Journal of Australia. “Interventions that do not have a demonstrable incremental clinical benefit should not be funded simply because they are new”, wrote Dr David Muller, Director of the Cardiac Catheterisation Laboratories at St Vincent’s Hospital in Sydney.
The availability of these devices, which include implantable defibrillators, devices for valvular heart disease, and left ventricular assist devices, is fast outpacing the availability of funding sources, Dr Muller wrote.
According to Dr Muller, new funding strategies are required if patients are to benefit from these major advances.
One potential measure – allowing uninsured public hospital patients who can afford to pay for certain interventions the opportunity to do so – should be open for debate, he wrote. Also, the system for gaining public hospital funding of new technologies has limitations, Dr Muller wrote.
“The approval process can be slow and inflexible.” However, even measures to reduce delays, such as streamlining administration, would not necessarily increase access for public patients. Ideally, the approval of complex new technologies should be accompanied by special-purpose funding that allows selected sites to develop expertise, obtain local cost-effectiveness data and provide follow-up and device surveillance.
A coordinated national approach to advanced technology funding may be “the most efficient and equitable, and provide the most timely access for patients to important medical advances in both the public and private health systems”, Dr Muller wrote.