Average price model may hurt patients

5 Feb 2021

The AMA has been actively advocating against an average price model for medical devices as the Federal Government considers changes to the prostheses list in the May Budget.

Under changes proposed by the Department of Health and private insurers, health funds would only have to pay the new average price for devices like hip and knee replacements, stents, and pacemakers, and surgeons could be prevented from choosing the best devices for their patients.

Dr Khorshid said reform is needed, but the average price model could lead to surgeons feeling pressured to make decisions based on what the health fund would pay for, not health outcomes, if something unexpected happened during surgery and it turned out a more expensive device was needed.

“I don’t want to have to be thinking ‘oh dear, the patient’s going to end up with a $2000 bill’ or maybe I’d be pressured not to use what’s in the patient’s best interest because of the cost implication,” Dr Khorshid told News Corp.