Personalised medicine: access to genetic testing in the Australian healthcare system
The Department of Health seeks to promote ‘better health and wellbeing for all Australians, now and for future generations’.
There is increasing consumer expectation for personalised medicine including a range of genetic testing, and for Medicare to fund these diagnostic health services. However, there are limited fiscal resources available to finance health expenditure in Australia – it is not currently economically feasible to screen every Australian for a range of rare genetic conditions.
What approaches and actions could Government take to determine how best to fund access to appropriate genetic testing in Australia?
Genomic and genetic testing is a rapidly evolving area of health technology.
Genetic conditions can have severe a and often fatal impact on affected individuals and their families. Many parents only discover they are genetic carriers for a serious health condition when their young child is diagnosed after birth.
The carrier incidence of many of these rare genetic conditions in the Australian population is low.
There are no current national programs in Australia to provide population screening of carrier status for any genetic condition.
Parents increasingly want to know whether they are at risk of passing on a genetic condition before they start a family.
There is increasing consumer expectation for personalised medicine including a range of genetic testing, and for Medicare to fund these diagnostic health services.
Before an item is listed for Medicare funding, it must go through a Health Technology Assessment (HTA) process to assess its safety, clinical effectiveness and cost-effectiveness.
You must balance community expectations regarding access to public funding for rapidly advancing health technologies with available evidence, sustainability of overall health care spending, and Government’s desire for policy and program options that are responsive to emerging technology.
In order for any service to be listed on the Medicare Benefits Schedule (MBS) it must first be assessed by the Medical Services Advisory Committee (MSAC). MSAC provides advice to Government on the level and quality of evidence relating to the comparative safety, clinical effectiveness and cost-effectiveness of such services. (http://www.msac.gov.au).
The first National Health Genomics Policy Framework (the Genomics Framework), developed by the Commonwealth in consultation with the jurisdictions, was agreed by the Council of Australian Governments (COAG) Health Council in November 2017. The Genomics Framework aims to help Australians to live longer and better through harnessing the benefits of genomics in an ethical, equitable, efficient and effective way to improve health outcomes for individuals and families. (http://www.health.gov.au/internet/main/publishing.nsf/Content/national-health-genomics-policy-framework-2018-2021).