Health insurers seek a halt to ‘$800m prosthetics wastage’

Health insurers have renewed calls for the federal government to address the high cost of prostheses.

Health insurers have renewed calls for the federal government to address the high cost of prostheses, with Medibank data showing some devices used in the private sector cost 700 per cent more than they do in the public sector.

After persistent complaints about the Prostheses List used in the private sector, the government last year agreed to legislate to cut the price of cardiac devices and intra-ocular lenses by 10 per cent, and hip and knee prostheses by 7.5 per cent. The move was expected to save insurers $86 million in the first year, putting downward pressure on insurance premiums, and saving $394m over five years.

While the government also ­appointed an advisory committee to look at prostheses pricing, a Senate committee has started ­examining the issue, adding to the number of reviews to have taken place in recent years. Terry Campbell, who chairs the advisory committee, told the Senate committee in a submission he was “of the opinion there is an ­opportunity and the need for change”.

Medibank told the committee nephrostomy catheters cost $15 in West Australian public hospitals but $120 on the Prostheses List, a 700 per cent difference. A pacemaker that cost $1920 in Western Australia cost $11,440 on the list (a 496 per cent difference), while a coronary stent that cost $300 in Queensland cost $1248 on the list.