South Australian Medicines Evaluation Panel in review: providing evidence-based guidance on the use of high-cost medicines in the South Australian public health system
Robyn Lambert
A K , Naomi Burgess A , Nadine Hillock A , Joy Gailer A , Pravin Hissaria A B C , Tracy Merlin A D E , Chris Pearson A F , Benjamin Reddi A C G , Michael Ward A H and Catherine Hill A C I J
A Medicines and Technology Programs, SA Health, Rundle Mall, Adelaide, SA 5000, Australia. Email: naomi.burgess@sa.gov.au; nadine.hillock@adelaide.edu.au; joy.gailer@sa.gov.au; pravin.hissaria@sa.gov.au; tracy.merlin@adelaide.edu.au; chris.pearson@sa.gov.au; benjamin.reddi@sa.gov.au; michael.ward@unisa.edu.au; catherine.hill@sa.gov.au
B SA Pathology, Adelaide, SA 5000, Australia.
C Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia.
D Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia.
E School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
F Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia.
G Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, SA 5005, Australia.
H School of Pharmaceutical, Molecular and Biomedical Sciences, University of South Australia, Adelaide, SA 5001, Australia.
I Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia.
J The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia.
K Corresponding author. Email: Health.MTPP@sa.gov.au
Australian Health Review 45(2) 207-213 https://doi.org/10.1071/AH20018
Submitted: 31 January 2020 Accepted: 3 August 2020 Published: 25 March 2021
Abstract
Objective The South Australian Medicines Evaluation Panel (SAMEP) was established in 2011 to make evidence-based recommendations on the funding of high-cost medicines in South Australian public hospitals via a high-cost medicines formulary. SAMEP represents one component of South Australia’s process for state-based health technology assessment (HTA). The aim of this study was to describe the experience of SAMEP in the context of Australia’s complex governance model for hospital-based care.
Methods A retrospective review was conducted of the SAMEP process and outcomes of medicine evaluations. Decision summaries and meeting minutes were reviewed and reflected upon by the authors to explore the views of the SAMEP membership regarding the function of the committee and state-based HTA more broadly.
Results SAMEP has reviewed 29 applications, with 14 (48%) listed on the high-cost medicines formulary. Three applications have been the subject of outcome review and confirm expectations of patient benefit.
Conclusion Retrospective review of the committee experience suggests that state-based HTA as operationalised by SAMEP is feasible, provides greater equity of access to high-cost medicines in the South Australian public hospital system and allows for access with evidence development.
What is known about the topic? State-based hospital funders often need to make decisions on the provision of high-cost medicines for which there is no national guidance or subsidy. Little published information exists about state-based approaches to medicines evaluation and reimbursement within public hospitals in Australia.
What does this paper add? The South Australian experience demonstrates a method for states and territories to tackle the challenges of providing evidence-based access to high-cost medicines in Australian public hospitals.
What are the implications for practitioners? This paper provides information for other jurisdictions considering state-based approaches to medicines evaluation and contributes to the broader literature about state-based HTA in Australia.
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