1724 – Cardiac technical support services provided by industry employed technicians

This application occurs in the context of the Prostheses List reforms, which aim to reduce the cost of medical devices used in the private health sector, improving affordability and value of private health insurance for Australians.

A key component of the reforms is staged benefit reductions over four years commencing July 2022, reducing the gap between public hospital prices and Prostheses List (PL) benefits paid for the same devices in the private sector.

Industry contends that PL benefit reductions for CIEDs will reduce their ability to provide technical support services for these devices. This application follows an agreement between the Government and MTAA for MSAC to assess and advise on the reasonable cost to industry for CIED technical support services provided by IECTs for patients who have their CIED funded through private health insurance.

Cardiac Implantable Electronic Devices (CIEDs) are battery powered electronic devices used to manage heart conditions including rhythm abnormalities.

Permanent pacemakers and implantable defibrillators are the best known examples, but they also include implantable loop recorders (ILRs) and cardiac resynchronisation therapy devices (CRTs).

Optimal device performance and longevity requires regular checks, with 1-4 scheduled services occurring each year, and others when needed due to new events or symptoms. Some of these services may occur remotely. Services help maintain device function, whilst communications with treating clinicians inform clinical management decisions. Industry Employed Cardiac Technicians (IECTs) provide essential equipment and undertake a significant amount of the cardiac support servicing in the Australian private healthcare system.

Type: Investigative

Cardiovascular disease is the leading cause of death worldwide. Abnormalities of heart function and rhythm are common conditions that require ongoing medical care.

CIEDs help diagnose, treat and monitor a range of cardiovascular conditions including bradyarrhythmias, ventricular tachyarrhythmias, atrial fibrillation and advanced systolic heart failure. Typically, these devices are implanted in patients at risk of sudden cardiac death or suffering from chronic heart failure.

• PASC consultation: Expedited – bypassing PASC
• MSAC consultation: Closed Friday 10 February 2023

• PASC meeting: Bypassing PASC
• ESC meeting: 9–10 February 2023
• MSAC meeting: 
  • 30–31 March 2023
  • 27 July 2023

MSAC provided advice on how to calculate the reasonable cost of cardiac technical support services. MSAC advised that it might be reasonable to include some services provided to public hospitals patients until reforms change how these services are funded.

MSAC advised that the current model of care for provision of CIED follow-up services that relies on industry is problematic and that cross-subsidising follow-up services through the Prostheses List benefit has resulted in an opaque mechanism of funding for these services.

MSAC advised that further reform should be undertaken to encourage uptake of other ways to provide this care. This may include private cardiologists who employ cardiac technicians directly to provide these services. MSAC advised that this would have to be addressed through longer-term reform.

See the public summary document for the full details of our advice.