Health treatments should be tested: experts

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Sunday, 1 March 2009

With the cost of healthcare drastically on the rise, researchers at the University of Adelaide are calling for more hard proof to show that medical treatments are effective and appropriate - and worth the money being spent on them.

In a paper published tomorrow (Monday 2 March) in the Medical Journal of Australia, researchers from the University's Discipline of Public Health say some current treatments may provide little to no benefit to patients in relation to their high cost, and in some cases may cause harm instead of good.

The researchers say a range of medical treatments should be assessed, with those that are not effective from a cost or medical point of view to be reduced or withdrawn, and the money reallocated to treatments that deserve it.

"More needs to be done to make healthcare in Australia cost-effective and beneficial for the greatest number of patients," says lead author Dr Adam Elshaug, from the research group Adelaide Health Technology Assessment (AHTA).

"We need to rethink how healthcare resources are allocated and on what basis they're allocated, especially as the cost of healthcare rises. We can improve the health system by making it more efficient and accountable, and enhancing quality of care, without necessarily asking for additional resources.

"By better understanding what medical practices work and those that don't, and by assessing appropriate use, we have an opportunity to provide a cost-saving or cost-neutral solution for the health budget. This would see resources move away from inappropriate areas and towards areas with greater demonstrated effectiveness. It would reduce the amount of unnecessary suffering and premature death arising from the use of treatments that deliver less than the best-available value for money," he says.

Dr Elshaug says he supports a recent call from the Australia 2020 Summit, saying: "We need to ensure that resources are allocated across the system based on hard evidence. Public funding should be added and removed on the basis of clearly demonstrated effectiveness."

Dr Elshaug and his colleagues recommend expanding the role of the Medical Services Advisory Committee (MSAC) to scientifically and transparently assess current practices and technologies, as well as new ones.

The paper provides a framework that could be used to help identify and prioritise treatments that are strong candidates for assessment. "A number of practices need to be evaluated to ensure Australians are receiving the best and most appropriate care as well as the best value from their tax dollar," he says.

According to the paper, total health expenditure is conservatively projected to rise from $71.4 billion in 2002-03 to $162.3 billion by 2032-33. This represents 10.8% of gross domestic product by 2032-33.

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