Category: Patients

DOES AUSTRALIA’S PRIVATE HEALTH SYSTEM NEED EMERGENCY TREATMENT?

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[vc_row][vc_column][vc_column_text]The Government has introduced a range of measures to increase affordability including the $1.1bn cuts to medical devices, providing discounts to under 30-year old’s and forthcoming classification of policies into gold, silver, bronze and basic.

Meanwhile Labor has promised a wide-ranging Productivity Commission review, the first in 20 years, during which it committed to capping annual premium increases to 2% for two years.

Australia has a fantastic health care system that delivers great patient outcomes for the money we spend. Health expenditure should not be a cost but an investment in our community by maintaining a healthy population.

The reality is, surgical volume growth is slowing, a sign that private health insurance (PHI) customers are either electing to delay procedures or go onto the public waiting list. And why might they be doing this? Cost.

Last week the ACCC released its annual report into the private health insurance industry, which called for the industry to make its products more consumer friendly by providing reliable and transparent information about product features and changes to private health insurance policies.

Dissatisfaction with PHI has reached that point that complaints to the Private Health Insurance Ombudsman (PHIO) have increased by 30%, continuing a trend of increasing complaints, which have risen for the fourth consecutive year.

The evidence of increasing profits and retained capital reserves by private health insurers would indicate scope for them to do more on their end.

The Medical Technology Association of Australia’s (MTAA) CEO, Ian Burgess, has pointed to the Prostheses List Agreement, co-signed with the Government, which has resulted in $1.1 billion in cuts, over four years, to assist with the affordability of private health insurance.

“More and more Australians are turning away from Private Health Insurance (PHI) because it is increasingly costly while covering less and less due to exclusions” Mr Burgess said.

“Just last week PHI was claiming a 2% cap on premium increases would lead to eight insurers operating at a loss in the first year and put three on the brink of insolvency in the second.  This is an industry that receives $6 billion in taxpayer subsidies every year.

“The public would be right to seriously question the fundamentals of the PHI industry, if it can’t deal with a 2% cap,” he said.

The increase in out-of-pocket costs is seeing patients not opting for elective surgery in private hospitals and instead going on our public waiting list.

According to a Credit Suisse analyst “utilisation in the short term as long as affordability pressures continue to shift patients into the public system and the government displays low appetite to produce meaningful reforms to reverse this trend.”

Australia’s largest private hospital provider Ramsay Health Care, revealed this problem recently.

“We are facing more challenging conditions in Australia with lower growth in procedural work and inpatient admissions, which has adversely impacted casemix in our Australian hospitals,” Ramsay’s managing director, Craig McNally, said.

“Given the current climate around private health insurance and affordability, we expect this trend will continue into 2019.”

The problem is exacerbated for the private hospitals who over recent years have aggressively increased the number of beds and brownfield sites, leaving them with a quagmire of less patients and more beds.

The Weekend Australian revealed that internal government documents had warned the Health Minister reforms were needed to prevent a decade-long decline in the sector.

The Office of Best Practice Regulation wrote that “Without a discussion of how consumers might take advantage of reforms to change their level of private health insurance, or how the take-up by younger people might be affected, it is difficult to see how the reform option as a package is intended to result in a net benefit for consumers, private health insurers and the community.”

Many across the healthcare sector have raised concerns that nothing in the next 12 months will see PHI increase its value proposition to consumers and ever increasing profits will only fuel the rage.[/vc_column_text][/vc_column][/vc_row]

DA VINCI ROBOTS ENTER HOSPITALS

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Distributed by Healthcare Company Device Technologies, the purchase will be a huge win for Victoria’s hospital system, expanding the existing Epworth fleet of three third generation platforms to six fourth generation systems across four hospitals. This will be the second upgrade and expansion of Epworth’s da Vinci Surgery program since 2003, when they purchased the first da Vinci Standard system in Australia.

Robotic technology is becoming an increasingly common site in Epworth hospitals, ranging from surgical da Vinci robots in operating theatres to TUG transport robots reducing manual handling across the hospital.

The da Vinci Surgical systems are sophisticated technology platforms, designed to enhance minimally invasive operations. Their design allows surgeons, through 3D vision and wristed instrumentation with intuitive, sensitive motion controls, to reach difficult areas in the human body and carry out complex procedures through minor incisions.

Since 2003, the technology has grown in its application and is now utilised in Urological Surgery, Cardiothoracic Surgery, General Surgery, Gynaecological Surgery and ENT surgery. It was recently used by Dr Ben Dixon, who performed Australia’s first paediatric robotic surgery on six-year-old Freyja Christiansen earlier this year.

The introduction of six more fourth generation da Vinci systems into the Victorian healthcare system was made possible by donations to the Epworth Medical Foundation.

In addition to increasing access to robotic surgery for patients, they will also turn Victoria into a hub for clinical research and robotic training, which will enable more surgeons to learn how to use these robots and apply their skills beyond the operating theatre.

“We were the first to bring da Vinci to this country, we fell behind a little in recent times and now we want to be back at the forefront in terms of technology, access, research and patient outcomes” Epworth said of the sale announcement.

Both Epworth Group Chief Executive, Dr Lachlan Henderson and Device Technologies General Manager for Robotic Surgery, Heath Priestly, said the landmark purchase was an important step forward for Victorian healthcare.

“Our significant investment in da Vinci Surgical technology is consistent with Epworth’s ongoing commitment to deliver quality innovative healthcare to patients in Victoria,” Dr Henderson said.

“Its 15 years since the first patient was treated for Prostate cancer with a da Vinci system at Epworth Hospital in Richmond. All this time later, and it feels like we are just beginning,” added Mr Priestly.

“These 6 new da Vinci systems, all with 4th generation technology, will open up a world of possibilities for clinicians and their patients.”

IMPACT OF MEDTECH 2018

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[vc_row][vc_column][vc_column_text]The event, which has almost become an annual fixture for the industry, saw the who’s-who in Australian medtech rubbing shoulders with policy-makers, staffers, senators and members.

The evening was kicked off by MTAA board chairman, Gavin Fox-Smith, who welcomed more than 100 attendees to the private dining room. Throughout the evening Fox-Smith invited a number of patients and surgeons to the stage to share their amazing stories of how medical technology changed, and in some instances, saved their lives.

One of those asked to speak was Dianne Sloan, whose husband, Brian, suffered a devastating ischaemic stroke in April of this year. Brian’s surgeon said the stroke would normally have either killed him or left him in a vegetative state. But thanks to the Trevo thrombectomy performed by the surgeon, Brian was able to make an excellent recovery, leaving hospital shortly after, and returning to a fulfilling life with his wife and grandchildren.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”2077″ img_size=”full”][vc_separator][/vc_column][/vc_row][vc_row][vc_column width=”1/2″][vc_single_image image=”2076″ img_size=”full”][/vc_column][vc_column width=”1/2″][vc_single_image image=”2078″ img_size=”full”][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_column_text]Lining the walls of the parliamentary private dining room were the various MTAA member companies’ displays, which showed off the very latest advancements in medical technology. PulseLine spotted Stryker’s Maurice Ben-Mayor giving a hands-on demonstration Stryker’s assisted surgery tool aka ‘Mako’ to Labor’s Shadow Minister Jason Clare.

After a busy Parliamentary sitting day, Shadow Treasurer Chris Bowen dropped by, and was seen chatting with the MTAA’s Ian Burgess and former NSW Deputy Premier John Watkins. Bowen was later joined by Shadow Communications Minister Michelle Rowland, and newly sworn-in Senator and former NSW Premier Kristina Keneally.

A big hit with MPs and Senator’s was Alcon’s Ophthalmology Surgery Virtual Reality Technology. PulseLine snapped photos of the Member for Bennelong John Alexander and Member for Makin Tony Zappia being guided through the experience by Robyn Chu and her team, as the Member for North Sydney Trent Zimmerman watched on.

The event was topped off with addresses from both Minister for Health Greg Hunt, and Shadow Minister for Health Catherine King.

It’s safe to say that this is definitely an event to put in your calendar for next year.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”2083″ img_size=”large”][/vc_column][/vc_row][vc_row][vc_column][vc_separator][vc_single_image image=”2084″ img_size=”large”][vc_separator][/vc_column][/vc_row]

Digital Health to Transform Australia’s Health System and Save Lives

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[vc_row][vc_column][vc_column_text]The report, developed after an expert roundtable initiated by the Consumers Health Forum and The George Institute for Global Health, says “the time is now ripe” to support the expansion of digital health technology in vital areas including chronic care and residential aged care.

The report is based on discussions held by around 40 consumers, clinicians, academics, government and industry supported by the Australian Digital Health Agency.

Roundtable attendees considered four sectors — chronic care, residential aged care, emergency care and end of life care — in terms of what is wanted from digital health, the current state of digital health in that sector and how to meet goals for the future.

The report says major progress is being made with My Health Record, e-prescriptions, patient registries, shared care portals, state-based digital health strategies and linked hospital patient information systems.

“The time is now ripe to leverage this maturing digital health capacity in ways that are meaningful to both consumers and providers. If done well, it has potential to be transformative for Australia’s health system bringing about rapid enhancements in quality, safety, accessibility and efficiency,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“Digital disruption is not coming in health care – it is already here. For too long health has been lagging behind other sectors.

“For Australia to embrace digital health and benefit from its huge potential, we need national leadership. The COAG National Digital Health Strategy provides a foundation but what is needed is stronger, coordinated direction from the federal, state and territory governments.

“It would be good news for consumers to bring health into the 21st century but we need to be mindful that people have differing levels of health literacy and some will need support to embrace a digital health future or we risk inequities of access and knowledge.

“We need to invest in implementation and change management to avoid the risks and pitfalls that can accompany the roll-out of such powerful technology into a complex and sensitive area like health care,” Ms Wells said.

Professor David Peiris, Director of Health Systems Science at The George Institute, said emerging digital health strategies had the potential to transform Australia’s health system for both health care providers and consumers.

“Our report sets out clear recommendations on what is needed to enable people to be much more in control of their own health needs and to make informed choices about the care they choose – from urgent life-saving situations through to respecting their wishes at the end their life.

“We also want to ensure that every health professional in Australia can take full advantage of the digital health eco-system to improve people’s healthcare experience and provide care that can be co-ordinated across the system. Many Australians are tired of having to constantly repeat their story to multiple care providers and it’s vital that we tap into digital technology to ensure we deliver a more person-centred, safer and sustainable healthcare system.

“Australia has made a great start in its uptake of digital health technology and we have identified practical steps in several areas that could be rolled out rapidly. The challenge now is to ensure they are adopted.”

The recommendations identified by the roundtable included:

In chronic care: To trial virtual care teams to support patients with high care needs; and trial a “Patients Like Me” platform to enable patients with chronic and complex care needs to safely connect and share experiences with one another.

In residential aged care: Ensure that residents’ health and social services information is available in a single location, on a platform easily accessible by consumers and providers anywhere, anytime and on any device. Collate and publicise data that allows patients, their carers and future consumers to compare residential care facilities based on health outcomes and patient experiences.

In emergency care: Develop digital health technologies that leverage My Health Record data to be rapidly accessible to paramedics and other emergency providers; develop a text/image message system to support improved communication between emergency care and other medical teams and assist with referrals to other health care providers for post-discharge care.

In end of life care: Develop and promote existing professional and consumer portals that provider information on care options, medical services and pathways for those nearing end of life; and engage in targeted social media campaigns to encourage consumers and medical professionals to normalise conversations about death.[/vc_column_text][/vc_column][/vc_row]

SUPPORTING AUSTRALIA’S PLAN TO BE A GLOBAL LEADER IN CLINICAL TRIALS

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[vc_row][vc_column][vc_column_text]Working with the state and territory governments, we will reduce red tape and end duplication, making it easier to conduct clinical trials in Australia.

This will mean Australian patients will have greater access to the world’s best medical breakthroughs.

Today at the global biotechnology and innovation convention in Boston, United States, I reaffirmed Australia’s commitment to be the world’s best destination for clinical trials.

We are providing $7 million to support states and territories to redesign their trial systems to make it easier for researchers and companies to conduct clinical trials.

This will ultimately mean Australian patients get first access to the best medicines, devices and treatments in the world.

The concept will be informed by a review of the clinical trial registry system in Australia.

Our commitment to clinical trials is rock-solid and it builds on our unprecedented investment in health and medical research.

We recently launched a national awareness campaign to get to get more Australians into ground-breaking clinical trials, opening up access to life-saving new medicines and treatments.

The Turnbull Government recently announced a $248 million investment to support clinical trials for Australian patients with rare cancers and rare diseases, and unmet need clinical trials and registries program.

In the 2018-19 Budget we announced our commitment to deliver $6 billion in record funding for Australia’s health and medical research sector, including $3.5 billion for the National Health and Medical Research Council, $2 billion in disbursements from the Medical Research Future Fund and $500 million from the Biomedical Translation Fund.

The foundation of the Government’s commitment to health and medical research is a new job boosting $1.3 billion National Health and Medical Industry Growth Plan, to improve health outcomes for hundreds of thousands of Australians, create tens of thousands of new jobs, and develop the next generation of Australia’s global leading industries.[/vc_column_text][/vc_column][/vc_row]

NSW BUDGET: FUNDING BOOST TO FIGHT HEART DISEASE

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[vc_row][vc_column][vc_column_text]Premier Gladys Berejiklian, Treasurer Dominic Perrottet and Health Minister Brad Hazzard said the landmark funding in the NSW Budget 2018 would start with a $60 million rollout to researchers over the next four years.

“Heart disease remains Australia’s number one killer but with greater investment, researchers can predict, prevent and treat it more accurately,” Ms Berejiklian said.
“If we want to keep people healthy, and reduce pressure on our clinical services, we have to curb the growing epidemic of cardiovascular disease.”

Mr Perrottet said: “Cardiovascular disease affects one in six Australians, and living with a heart condition can be frightening. It is critical we make this investment in long-term research funding for the wellbeing of NSW.”

Heart disease kills one person every 12 minutes.

Mr Hazzard said the 10-year funding certainty makes NSW an immensely attractive option to cardiovascular disease researchers and clinicians from around the world.
“We need skilled partners to beat heart disease and this investment guarantee will make us the first choice for researchers, the pharmaceutical sector and biotechnology industry,” said Mr Hazzard.

“The funding pipeline also allows us to support more clinical trials and leverage the existing research already underway across institutes, hospitals and universities.”

“We are committed to partnering with industry to grow health and medical research jobs, and bring new discoveries to market as quickly as possible to benefit individuals and their families, as well as the broader NSW economy,” said Mr Hazzard.

The record investment builds on the work of the Cardiovascular Research Network, a collaborative of 15 member organisations and more than 50 affiliated research institutions supporting cardiovascular research and the NSW research workforce.

The Heart Foundation’s NSW CEO Kerry Doyle said: “The NSW Government has shown vision and foresight in making this commitment, guaranteeing the next generation of research excellence and first-class care for the community.”

The Victor Chang Cardiac Research Institute’s Executive Director Professor Robert Graham said: “With this initiative, we will be able to rapidly convert groundbreaking discoveries into better treatments for patients with heart disease.”[/vc_column_text][/vc_column][/vc_row]

10 PER CENT “A VERY SMALL NUMBER”

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[vc_row][vc_column][vc_column_text]It was good to see official recognition of the contribution the MedTech sector has made to keeping this year’s PHI premium increase to the lowest it has been in years.

With the industry having contributed over $1 billion in cuts that goes directly into the bottom lines of PHI companies and their promise to ‘pass on every dollar’ in savings to consumers, it was heartening to see the Department of Health officially recognise MedTechs role.

In evidence to the Senate Estimates Committee the Department of Health stated the MTAA Agreement with the Government has directly resulted in delivering the lowest premium increase in 17 years.

Ian Burgess, Chief Executive Officer of the Medical Technology Association of Australia said “we welcome comments from the Department of Health that our Agreement has directly resulted in delivering the lowest premium increase in 17 years, which has been directly attributed to the $1.1 billion cuts in revenue to the medical device industry.

“The medical technology industry believes access to a full range of medical technology is the most valuable component of a private health insurance policy and we’re committed to doing what we do best – assist patients lead healthier and more productive lives.”

What is clear is that the MedTech industry has done some heavy lifting in regard to aiding Australian consumers in helping to keep PHI premium increases as low as possible.

It is a shame that the PHI insurance has not done the same and continues to blame everybody else.

Only this week Medibank CEO Chris Drummond was in the press complaining about how they have no control over their claims or costs. Laying the blame at the feet of the medical profession as the main driver of claims he stated, “We control our own costs which is 10% of what we pay out”.

He makes no mention though of looking at PHI costs, profits or excess capital.

According to Mr Drummond they have a $600m management cost base and pay $5.2b in claims. This is a cost to claims ratio of 11.5%. Is this acceptable or not? That is a good community debate to have.

It is also very telling though that Mr Drummond has said if Labor win and impose a 2% premium cap, then they will most likely seek to cut payments to dentists, physios and hospitals. This means even less value for money for PHI policy holders.

“MTAA strongly supports the need for a healthy and viable private health insurance sector in Australia,” said Mr Burgess.

“But we’ve always maintained that given we represent 10% of private health insurers overall costs a reduction in costs for medical technology would only ever result in a modest reduction in premium increases.[/vc_column_text][/vc_column][/vc_row]

Medtech’s Growing Role in Clinical Trials in Australia

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[vc_row][vc_column][vc_column_text]The country’s regulatory environment and organizations such as the MTAA have helped to nurture the increasing interaction between industry and clinical researchers, ushering in more trials that help to improve medical therapy and offer benefits to both patients and the economy. In celebration of International Clinical Trials Day, let’s take a look at the study landscape in Australia and how it has transformed in recent years.

Medical device companies are playing an increasingly important role in Australia when it comes to clinical research. The number of new clinical trials involving medical devices increased greatly by 12.6% annually between 2010 and 2015. In comparison, the growth rate for new pharmaceuticals trials was only 2.7% during the same period. Overall the number of new trials rose by 4.7%.

A number of global medical technology companies are already taking advantage of the favourable conditions that Australia offers for early-phase clinical trials. The regulatory environment is conducive to first-in-man studies and there are dedicated research teams with a strong commitment to data quality. However, more needs to be done for Australia to remain competitive in the international clinical trials landscape. Especially when it comes to early phase studies, time is essential. Recent reforms have targeted limitations such as slow study start-up due to duplication of ethical review of the same study across multiple hospital sites. The MTAA plays an active role in informing public debate as well as government during the reform process via its Clinical Investigations Forum which was formed in 2011.

Fundamentally, clinical trials with medical devices serve patients. They benefit from access to the latest technologies that may not yet be available commercially, advice from and treatment by leading medical practitioners, and, in many cases, closer monitoring of their treatment. Moreover, from a healthcare system perspective, clinical research promotes the use of best evidence in medical decision-making based on health economic value. A vibrant clinical trials infrastructure attracts academic talent with positive flow-on effects for hospitals, communities and even the entire country. Clinical trials have a positive economic impact as well. Not only through the direct investment in clinical studies and infrastructure, but also by rigorously testing innovative technology, thus preparing it for market launch based on solid clinical evidence. For those reasons, the Australian government continues to strongly support clinical research activity.

An example of a recent and potentially guideline-changing trial is CASTLE-AF, which was conducted with BIOTRONIK’s support. The multicentre trial showed a 38% reduction in the composite endpoint of all-cause mortality and hospitalization for worsening heart failure, when catheter ablation was used to treat heart failure patients with atrial fibrillation (AF). All patients in the study had implantable cardioverter-defibrillators or cardiac-resynchronisation defibrillators with BIOTRONIK Home Monitoring technology. The reduction was observed when comparing these patients to patients treated with the pharmacological therapy recommended by current guidelines.

Dr. Johannes Brachman, Coburg Clinic, Germany, who led the trial together with Dr. Nassir Marrouche, CARMA Center, University of Utah, Salt Lake City, US, said: “These findings indicate heart failure patients with coexisting AF should be treated with catheter ablation as a first-line therapy.” The CASTLE-AF study thus contributes to enriching clinical knowledge and further developing therapy options for heart failure patients. Notably, this clinical trial also included two Australian investigators (Dr. Prash Sanders, Royal Adelaide Hospital, Adelaide, SA and Dr. Paul Martin, Royal Brisbane and Women’s Hospital, Brisbane, QLD).

When conducting clinical trials, medtech companies follow strict ethical principles. Each trial needs to be assessed by an independent Human Research Ethics Committee prior to being allowed to commence. The safety of the individual patient in a clinical trial always has priority over the trial itself. Patients choose whether or not to participate and they can withdraw their consent at any time.

On the occasion of International Clinical Trials Day we recognize clinical research and the people that make that research possible. The medical device industry is very fortunate to work with Australia’s brightest and most dedicated clinical research professionals for the benefit of our patients. We congratulate them on their achievements.[/vc_column_text][vc_zigzag][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_single_image image=”1971″ img_size=”full”][/vc_column][vc_column width=”3/4″][vc_column_text]

ABOUT THE AUTHOR

Falko Thiele, is the Director Clinical and Regulatory Affairs at Biotronik.[/vc_column_text][/vc_column][/vc_row]