The following tables show the key differences between the pre-reformed MSAC process and the reformed MSAC process.

Table 1: When an Application is received

Pre Reform MSAC Process	Reformed MSAC Process
All applications are accepted in any state. No requirement to provide key evidence or letters of support up front in the application form.	Applications must be checked for completeness. If they are incomplete, they will be returned to the Applicant. Applications must include a list of key journals or research published (or yet to be published). Applications must include a list of professional bodies/organisations representing the proposed medical service and have a letter of support for each nominated group attached.

Table 2: Suitability for Assessment

Pre Reform MSAC Process	Reformed MSAC Process
All applications are found suitable for MSAC consideration.	The department will assess the suitability of each application against the Process Framework.
A strategy template (outlining the application and its pathway) is signed off by the departmental delegate.	An Application Progression Record (APR) is created (outlining the application and its pathway) and is acknowledged by the applicant and signed off by the departmental delegate. The APR will be updated and checked throughout the application’s MSAC process as needed.

Table 3: PICO Confirmation

Pre Reform MSAC Process	Reformed MSAC Process
Public consultation, via the MSAC website, can occur on the Protocol, prior to a PASC meeting	The application form is sent for targeted public consultation. Stakeholders for targeted public consultation will be identified by both the applicant and the department.
Public consultation, via the MSAC website, can occur on the Protocol, after a PASC meeting.	The application form will remain on the MSAC website for public consultation at any time during the MSAC process.
The Protocol is prepared by the applicant or a contracted HTA group – whichever the applicant prefers.	The PICO confirmation is prepared by a contracted HTA group with applicant input.
The Protocol is published on the MSAC website for a formal public consultation period, however, consultation will be accepted at any time in the MSAC process.	The ratified PICO confirmation is published on the MSAC website for public consultation at any time in the MSAC process.
All applications must be considered by PASC.	If deemed appropriate by the department and the MSAC Executive, some applications will by-pass PASC and will not have a PICO confirmation developed.
A two PASC consideration pathway is available.	No change.
Progression of an application to the assessment stage is at the discretion of the applicant.	APR checkpoint - Progression of an application to the assessment stage is at the discretion of PASC, the MSAC Executive and the Department.
The applicant can elect to be present at the PASC meeting.	No change.

Table 4: Application Assessment

Pre Reform MSAC Process	Reformed MSAC Process
The applicant chooses whether they wish to proceed down a contracted assessment pathway or a submission based assessment pathway.	APR checkpoint. The APR will outline whether the application will proceed down a contracted assessment pathway or a submission based assessment pathway. The department will make the final decision on this in collaboration with the Applicant.
Finalised submission based assessment reports are provided to a HTA group for critique.	At the request of the applicant, a two stage assessment approach may also be undertaken. This will lengthen timeframes but will allow an applicant to ensure their clinical claim is correct before preparing their economic evaluation.
ESC reviews the assessment report, critique, applicant comments and other papers and identifies issues that MSAC will consider via an ESC report.	All finalised assessment reports will be provided to an independent HTA group contracted by the department for a critique. ESC reviews the assessment report, critiques, applicant comments and other papers and identifies issues that MSAC will consider via an ESC report.

Table 5: Appraisal

Pre Reform MSAC Process	Reformed MSAC Process
MSAC undertakes a rigourous and transparent appraisal of the evidence presented to them by ESC before advice is provided to Government for consideration	No change.
MSAC’s advice to the Minister of Health is made public on the MSAC website via a Public Summary Document, which explains the rationale for MSAC’s advice.	No change.