Australia’s Health Technology Assessment (HTA) system has served us well, but the time has come for meaningful reform. As chair of the HTA Review Reference Committee, I have had the opportunity to reflect on what works, what does not, and what is needed to create a system that supports faster access to innovation while maintaining the rigour and integrity that underpins our public health system.

The recommendations from the HTA Review are focused on creating a more flexible, transparent and inclusive system. One that is better equipped to evaluate the complexity of modern health technologies and the diversity of patient perspectives. At its heart, HTA must be seen as more than a funding mechanism. It is a tool that can build trust, drive  nnovation and support value-based care.

Why Reform Matters

Australia has a strong record in HTA. The system is respected globally and has delivered significant public health benefits. But technology has changed. Health systems have changed. Patient expectations have changed. We are now dealing with complex therapies, targeted treatments, digital technologies and evolving models of care.

In this new landscape, we need an HTA system that can keep up. That means reducing duplication, ensuring that processes are proportional to risk, and embracing new types of evidence without compromising decision quality.

We heard from patients, clinicians, consumer organisations, industry and researchers during the review. They told us that the current system can be slow, opaque and difficult to navigate. This is not just a bureaucratic issue.

Delays and uncertainty have a direct impact on access to care, on innovation and on health outcomes.

Principles for a Modern System

The HTA Review sets out a vision grounded in three key shifts.

First, the system must become more transparent. Decision-making criteria, data interpretation and priority setting should be clear and accessible.

Stakeholders must understand how and why decisions are made, even when those decisions are difficult.

Second, the system must become more consistent and proportionate. We need a unified policy framework across government programs and product types. And we need to calibrate our processes to the level of complexity and risk. Not every submission requires the same level of scrutiny.

Third, we must embed flexibility. Emerging technologies, from digital diagnostics to advanced therapeutics, do not always fit into traditional assessment models. We need the capacity to evolve, test new pathways and engage earlier with developers and patients.

A Focus on Early Advice and Co-Design

One of the most important changes is the recommendation for early advice and structured consultation. This is not simply about speeding up timelines.

It is about improving the quality of submissions, setting clear expectations and creating shared understanding from the outset.

The idea of co-design features prominently in the review. Whether it is a new digital health tool or a complex combination therapy, developers, patients and assessors must come together earlier and more often.

This collaboration can help surface challenges before they become barriers and reduce the need for lengthy post-submission negotiation.

Elevating the Patient Voice

Patients are not just beneficiaries of health technology. They are users, contributors and often the best advocates for evidence that matters in real life. Incorporating the lived experience of patients must be more than a token gesture. It must be structurally embedded in HTA processes.

We have recommended stronger consumer engagement frameworks, support for patient organisations to participate meaningfully and better integration of patient-reported outcomes and quality-of-life data. This iis part of building legitimacy and trust in the system.

Moving From Report to Action

The review is complete, but the work is not done. Implementation will be key. That requires coordination across government, industry and the health system. It will also require sustained investment in regulatory science, data infrastructure and workforce capability.

Reforming HTA is not about lowering the bar. It is about making sure the bar is in the right place for the technologies and expectations of today. It is about designing a system that supports faster, fairer access to innovation and delivers better health outcomes for all Australians.

That is a goal worth striving for.