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Australian Government Department of Health and Aged Care
Australia
The Prostheses List details the prostheses that private health insurers must pay a benefit for and the circumstances when this benefit must be paid. It was introduced in 1985 to reduce hospital waiting lists for procedures involving surgical implants and prostheses.
There have been a number of reforms to the Prostheses List since its inception. The 2021–22 Budget allocated $22 million to improve the Prostheses List through a range of measures, including:
The Prostheses List Advisory Committee selected 4 product categories to trial a post-listing review framework; one of these categories was surgical guides and biomodels (which are non-implantable devices used in surgical planning and decision making across a range of surgical contexts).
The department commissioned AHA to review surgical guides and biomodels on the Protheses List, consider whether they were eligible for listing and advise if a further cost-effectiveness review was required. To do this, we considered the role of surgical guides and biomodels in clinical practice, how and when they are being used, and evidence of their clinical benefits and effectiveness.
This 4-month project involved:
We synthesised the data collected from these sources and produced a final report which included findings regarding the products’ eligibility for listing on the Prostheses List. The report is now available on the department’s website.
This review considered the role, use, and benefits of surgical guides and biomodels in clinical practice.