Impacts of Advances in Medical Technology in Australia

Contents

Preliminaries
Cover, Copyright, Foreword, Terms of reference, Contents, Abbreviations and explanations, Glossary, Key Points, Overview

1   Introduction
1.1   About this study
1.2   Background to the study
1.3   Medical technology and the Australian healthcare system
1.4   Scope of the study
1.5   Conduct of the study
1.6   Report structure

2   The market for medical technology
2.1   Key demand drivers
2.2   Supply of medical technology
2.3   Conclusion

3   Aggregate impact of medical technology on expenditure
3.1   Techniques to measure the impact of technology
3.2   The residual approach
3.3   The direct approach

4   Individual technology expenditure impacts
4.1   Which technologies have driven the increase in healthcare expenditure?
4.2   Expenditure impacts of individual technologies
4.3   Funding responsibilities and expenditure on technology
4.4   Summing up

5   Benefits of advances in medical technology
5.1   Measuring outcomes
5.2   Health outcomes in Australia
5.3   Linking outcomes to advances in medical technology
5.4   Conclusions

6   Distribution of the benefits of new medical technology
6.1   Defining appropriate access
6.2   Measurement issues
6.3   Who has access to new medical technology
6.4   Explaining differences in utilisation rates
6.5   Conclusion

7   Cost effectiveness of advances in medical technology
7.1   Assessing aggregate net benefits of advances in medical technology
7.2   Cost-effectiveness analysis
7.3   Cost effectiveness of broad categories of technology
7.4   Cost effectiveness of individual technologies
7.5   Conclusion

8   Health technology assessment in Australia: an overview
8.1   Defining health technology assessment
8.2   Identifying gaps in HTA processes
8.3   Overview of HTA arrangements
8.4   Key gaps
8.5   Summary

9   Health technology assessment: pharmaceuticals
9.1   Assessment processes
9.2   Methodological issues
9.3   Procedural issues
9.4   Post-assessment processes

10   Health technology assessment: procedures, devices and ICT
10.1   Key differences in HTA between pharmaceuticals and other technologies
10.2   Medical procedures
10.3   Prostheses and devices
10.4   Information and communications technology
10.5   Post-assessment processes

11   Future advances in medical technology
11.1   Background
11.2   Technology development process
11.3   Projected disease burden
11.4   Likely advances in medical technology
11.5   Illustrative expenditure impacts of some future advances in medical technology
11.6   Conclusions

12   Conclusions and future policy challenges
12.1   Conclusions
12.2   Future policy challenges

APPENDICES

A   Public consultation

B   Measuring health and economic outcomes
B.1   A framework for economic evaluation
B.2   Single-dimension health outcome measures: data issues
B.3   Incorporating quality of life
B.4   Combining quality and quantity of life
B.5   Measuring and isolating economic benefits and costs: the issues
B.6   Other measurement issues

C   Health technology assessment in other countries
C.1   Canada
C.2   Denmark
C.3   France
C.4   Sweden
C.5   The Netherlands
C.6   United Kingdom
C.7   United States
C.8   Concluding comments

D   Case studies: an overview

E   Joint replacement surgery
E.1   Introduction
E.2   Number of procedures
E.3   Expenditure
E.4   Benefits
E.5   Cost effectiveness
E.6   Future developments
E.7   Conclusion

F   Statins
F.1   Introduction
F.2   Number of prescriptions
F.3   Expenditure
F.4   Benefits
F.5   Cost effectiveness
F.6   Future developments
F.7   Conclusion

G   Selective Serotonin Reuptake Inhibitors
G.1   Introduction
G.2   Use and expenditure
G.3   Benefits
G.4   Cost effectiveness
G.5   Future developments
G.6   Conclusion

H   Drug eluting stents
H.1   Introduction
H.2   Use
H.3   Expenditure
H.4   Benefits
H.5   Cost effectiveness
H.6   Future developments
H.7   Conclusion

I   Trastuzumab (Herceptin)
I.1   Introduction
I.2   Need and use
I.3   Expenditure
I.4   Benefits
I.5   Cost effectiveness
I.6   Future developments
I.7   Conclusion

J   PSA tests for prostate cancer
J.1   Introduction
J.2   PSA use and expenditure
J.3   Benefits of PSA testing
J.4   Cost effectiveness of PSA testing
J.5   Future developments
J.6   Conclusion

K   Information and communications technology
K.1   ICT and health — the context
K.2   Health ICT in Australia — the big picture
K.3   Major ICT administrative and support initiatives
K.4   Potential benefits of ICT initiatives
K.5   Costs and cost effectiveness of ICT initiatives
K.6   Telehealth and telemedicine
K.7   ICT — concluding comments

L   Genetic testing of women for breast cancer
L.1   Introduction
L.2   Need and use
L.3   Expenditure
L.4   Benefits
L.5   Cost effectiveness
L.6   Future
L.7   Conclusion

M   Cataract surgery
M.1   Introduction
M.2   Cataract surgery — use and expenditure
M.3   Benefits
M.4   Cost effectiveness
M.5   Future developments
M.6   Conclusion

References