One of the biggest advancements in medical technology is in the diagnostic assessment of patients through Magnetic Resonance Imaging technology or the MRI scan as it is more commonly known.
The history of MRI can be traced all the way back to 1971 when physician and experimenter Raymond Damadian discovered that the hydrogen signal in cancerous tissue is different to that of healthy tissue because tumours contain more water.
Jump forward a few years and in 1977 Raymond Damadian built the first MRI scanner and achieved the first MRI scan of a human body. A truly amazing technological achievement.
As with most medical technology, questions of cost and access are always at the forefront of public debate and a constant challenge for policy makers to be able to meet public expectations.
Recently, the Senate Community Affairs References grappled with this very issue through its’ inquiry into access to diagnostic imaging equipment around Australia.
A key focus of the inquiry was how are MRI licences granted and who gets them. What is the process and how does it work?
Unlike with pharmaceuticals which is subject to a rigorous process of independent assessment via the pharmaceutical benefits advisory committee (PBAC) no such process exists for a sponsor wanting to apply for a full Medicare rebate able MRI licence.
MRI licences are granted solely by the Minister for Health of the day. Consequently, successive Governments have been left open to the accusation that MRI licences are granted to meet political objectives as opposed to patient need based on such key criteria as population growth and changing demographics.
To emphasise the importance of this point the Senate Committees first recommendation was that:
“…. the Commonwealth Government immediately implement an application process with clear, objective and transparent assessment criteria to permit hospitals and radiology practices to apply for licences for Magnetic Resonance Imaging machines”.
With Australia facing an increasing ageing demographic and the welcome fact that we are all living longer, community expectations will always be a constant challenge for policy makers when it comes to access to medical technology.
Access to diagnostic imaging services like MRI scans is but one example of this constant challenge.
Financial resources are always limited and finite, yet Government will always face the constant demand to fund more health services, more pharmaceuticals and new medical technology.
For any Government allocating scarce resources, particularly in health then transparency should be welcome and more help than hinderance.
While there are regular complaints with the speed at which some new and innovative drugs get listed on the PBS, the independence of the PBAC is never called into question, for the simple fact that it is an independent process.
For diagnostic imaging services and in this case access to MRI licences, the lack of an independent process for allocating those licences, will leave the Government of the day open to criticism as to the allocation of those licences.
With the Senate Report now handed down, the ball is now in the Governments court as to how they respond to the recommendations.
The community should know in the next few months what the Government response will be to this challenging issue.
ABOUT THE AUTHOR
Jody Fassina is the Managing Director of Insight Strategy and has been an strategic adviser to MedTech and pharmaceutical stakeholders.