Key Insights from ARCS 2024: Shaping the Future of HTA and Reimbursement in Australia

EVERSANA’s senior director of pricing and market access for the APAC region, Amish Chaturvedi, recently chaired four insightful panel sessions discussing reimbursement policies at the annual ARCS Conference in Australia, covering key policy topics that impact the pharmaceutical, medical devices and diagnostics sectors in Australia. Here are some key takeaways:

1. Patient-centricity in HTA: This session highlighted the importance of integrating patient perspectives into health technology assessment (HTA) processes with improved transparency and greater accountability. It also demonstrated the need for more robust value frameworks to capture real-world patient experiences and outcomes to improve the relevance of HTA and aid coverage decisions. The panel, comprising Industry leaders and top patient advocates, stressed the value of co-designing HTA methodologies with patients to ensure their voices shape healthcare decisions.
   
   Key learnings: Patient input can significantly enhance the relevance and acceptability of HTA outcomes, and collaborative efforts are essential for meaningful patient engagement.
2. Reimbursement challenges for digital technologies: This session focused on the hurdles digital health technologies face in achieving reimbursement. Two primary challenges were identified by top industry speakers and MTAA: the lack of a dedicated reimbursement pathway for digital health with standardized evaluation criteria and the need for policy “agility” to embrace rapid evolution of digital health solutions.
   
   Key learnings: Australia is falling behind similar countries in the reimbursement of digital technologies. Establishing clear, standardized assessment frameworks and aligning regulatory approaches with technological advancements are critical for facilitating the adoption of digital health technologies.
3. The Australian HTA review: This session focused on the ongoing review of the Australian HTA system, with an emphasis on improving efficiency and transparency. The panel highlighted the importance of stakeholder engagement and the need for a more flexible, adaptive HTA system to address emerging healthcare innovations. The final recommendations of the recently concluded HTA review have been sent to the Australian government, and stakeholders are urging lawmakers to release them to the public.
   
   Key learnings: Continuous stakeholder involvement and an adaptable HTA framework are crucial for maintaining a responsive and effective assessment system.
4. Convergence of technology: Drug, device and diagnostics: The convergence of medicines and medical technologies presents unique reimbursement challenges. This session provided an analysis of the current codependent submissions reviewed by the MSAC in Australia. The panel underscored the necessity for more streamlined integrated evaluation pathways that reduce delay in access to targeted and personalized medicines in Australia.
   
   Key learnings: The current, complex evaluation system, which involves separate processes, is a disincentive for new technologies. Developing cohesive evaluation pathways, as recommended in the HTA review options paper, is an important part of navigating the convergence of medicines and medical technologies.

These discussions underscore the dynamic nature of healthcare innovation and the need for adaptive, patient-centered approaches in HTA and reimbursement processes.