Guidelines for preparing assessments for MSAC
These guidelines help developers understand what evidence is needed to get new medical imaging technologies funded by Medicare in Australia through the Medical Services Advisory Committee (MSAC). The main factors that influence funding decisions are how well the test improves patient outcomes and whether it is cost-effective.
At a glance
Use when
Preparing health technology assessment submissions for new imaging tests seeking public funding in Australia
Avoid when
Assessing non-imaging technologies or private funding applications where MSAC criteria do not apply
Inputs
Clinical evidence (quality, quantity, consistency), diagnostic accuracy data with appropriate reference standards, cost-effectiveness analyses, patient outcome data, financial impact estimates
Outputs
Recommendation for public funding or rejection of a medical imaging service by MSAC
How it works
The guidelines are informed by an analysis of 42 imaging test applications and 91 clinical indications assessed by MSAC between 2006 and 2021. Key criteria include quality, quantity, and consistency of clinical evidence, appropriateness of diagnostic reference standards, and robust cost-effectiveness analyses. Uncertainty in cost-effectiveness was the strongest predictor of negative funding decisions in multivariate logistic regression models with clustered data adjustments.
- HTA domains
- Clinical Effectiveness, Costs & Economic Evaluation, Patient and Social Aspects
- Categories
- AppraisalCost-effectiveness ModellingEvidence SynthesisReporting Standards & Best Practice
- Assumptions
- That improvements in diagnostic performance translate to meaningful patient outcomes; that cost-effectiveness can be reliably modeled using available evidence; and that the submitted data accurately represent real-world effectiveness and utilization
- Strengths
- Evidence-based framework aligned with actual MSAC decision patterns; emphasizes both clinical utility and economic viability; informed by retrospective analysis of real funding decisions
- Limitations
- Focuses primarily on imaging technologies; may not fully apply to other health technologies; reliance on published MSAC documents which may lack granular detail
- Also known as
- MSAC assessment guidelines, Medicare funding guidelines for imaging, MSAC evidence requirements
Questions this answers
- › What clinical evidence is required for MSAC funding approval?
- › How important is cost-effectiveness in MSAC decisions?
- › What are common reasons for MSAC rejecting imaging technologies?
- › How should diagnostic accuracy be evaluated for MSAC submissions?
- › What impact does evidence quality have on funding outcomes?
- › How can developers improve their chances of receiving public funding?
References & sources
Similar by meaning
- PBAC Guidelines (Guidelines for preparing a submission to the Pharmaceutical Benefits Advisory Committee, Version 5.0)
- Australian Managed Entry Scheme (MES)
- SMC Decision Modifiers Framework
- MSAC evaluation framework for genetic and genomic tests (value-of-knowing / personal utility)
- SMC New Product Assessment Form (NPAF)
Beta record. Generated from the primary source via AI extraction and independent audit, pending final human review.