- Highly specialised therapies are new high-cost treatments (more than $200,000 per patient) delivered at selected public hospitals only.
- Highly specialised therapies are formally assessed and recommended for funding by the Commonwealth Government's Medical Services Advisory Committee (MSAC), and are jointly funded by Commonwealth and State and Territory health departments.
- State and Territory health departments determine who provides approved highly specialised therapies to public hospitals.
The 2020–25 National Health Reform Agreement (NHRA) is committed to improving health outcomes for Australians by:
- providing better coordinated and joined-up care in the community
- ensuring the future sustainability of Australia’s health system.
It explains how the Commonwealth and State and Territory Governments contribute funding for public hospital services
Schedule C of the NHRA provides information about how all governments will support delivery of new life-saving high-cost therapies. Highly specialised therapies funded under the NHRA support national access to treatment for patients with rare conditions who often have few options remaining.
As of 1 July 2022, currently funded highly specialised therapies are:
- The CAR T-cell therapy, Kymriah, for treating
- relapsing/refractory acute lymphoblastic leukaemia in those aged 25 and under (delivered at The Royal Children's Hospital (RCH), The Peter MacCallum Cancer Centre (Peter Mac)); and
- relapsing/refractory adult diffuse large B-cell lymphoma (delivered at Peter Mac and Alfred Health)
- The CAR T-cell therapy, Yescarta, for treating relapsing/refractory adult diffuse large B-cell lymphoma (delivered at Peter Mac and Alfred Health)
- The gene therapy, Luxturna, for treating inherited retinal dystrophies (delivered at Royal Victorian Eye and Ear Hospital)
- The immunotherapy, Qarziba, for treating high-risk neuroblastoma (delivered at the RCH).
The national Framework for the assessment, funding and implementation of highly specialised therapies and services was developed in collaboration with the Commonwealth, State and Territory governments and other relevant stakeholders.
This framework provides guidance concerning assessment and nationally consistent commissioning of approved highly specialised therapies in selected public hospitals across Australia.
Executive advisory committee
A departmental executive committee will be established to provide oversight and decisions concerning highly specialised therapies, including:
- submission review and feedback to MSAC
- providing oversight on the process to identify and approve provider sites
- providing oversight on the implementation and review of relevant data reporting, acquittals and (where relevant) re-assessment.
The committee will seek expert clinical advice through the Victorian Health Technology Advisory Group and clinicians as required.
Reviewed 11 August 2022