Federal government reform of medical device pricing to give headroom to fund the latest technologies

30 Jun 2021Media Releases

Privately insured Australians with serious heart conditions now have a new, less invasive treatment option available, with MitraClipTM now funded through private health insurance.

MitraClipTM is a world’s first transcatheter mitral valve repair (TMVr) therapy that provides select people living with mitral regurgitation (a leaky heart valve) with a minimally invasive treatment option, avoiding the need for open heart surgery.

The device is a small metal clip covered with a polyester fabric that is implanted in the mitral valve. The device repairs leaky mitral valves and is delivered to the heart through a small incision in the leg. The therapy works by grasping together portions of the leaflets, or flaps, of the mitral valve to reduce mitral regurgitation, which allows the heart to pump blood more efficiently, thereby relieving symptoms and improving patient quality of life.

The device is expensive – more than $26,000 just for the device and delivery system (without including doctor or hospital fees which are covered separately) – and it will be covered for private patients with appropriate private health insurance cover from 1 July.

“This new device will improve quality of life for hundreds of Australians over the next few years, reducing the need for open heart surgery,” said Dr Rachel David, CEO of Private Healthcare Australia.

“Medical technology can be lifesaving, improve quality of life and provide massive benefits to Australian families. I’m pleased that new, innovative technology such as MitraClipTM is available for private patients. This device is expensive, but it provides value to the consumer and to the Australian community.”

Private Healthcare Australia is currently campaigning for lower prices for generic medical devices, which are often 30% higher for Australians than for people living in countries like the United Kingdom, South Africa and New Zealand.

“MitraClipTM is actually a good example of why we need to reform prices. We need to stop paying over the odds for older, generic technology which has become commoditised and invest more into new, innovative technology and reward innovation,” Dr David said.

MitraClipTM is available for limited clinical indications from 1 July 2021. The Medical Services Advisory Committee public summary document for MitraClipTM is can be found at this link.

Description of Medical Condition

(from the Medical Services Advisory Committee public summary document for MitraClipTM link.)

Mitral regurgitation occurs when the leaflets (or flaps) of the heart’s mitral value do not close properly and leak. The mitral valve is a one-way valve that separates the left atrium (a chamber in the heart which collects blood from the lungs) from the left ventricle (a chamber in the heart which pumps blood to the rest of the body). During left ventricular systole, the leak in the mitral valve causes blood to flow backwards into the left atrium (also known as regurgitant volume), thereby decreasing blood flow to the body (resulting in lower cardiac output and stroke volume).

To maintain blood flow to the body and compensate for mitral regurgitation, the left ventricle must increase its contraction. Backflow due to mitral regurgitation places an extra burden on the left ventricle and lungs. Eventually, this burden can cause other problems, such as: stroke, sudden death, irregular heartbeat, increasing damage to the heart muscle (progressive myocardial injury); and/or inability to maintain adequate circulation of blood (congestive heart failure).

 

ENDS

 

Media contact: Jen Eddy, 0439 240 755

 

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