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Restricting access to new medicines: beyond the outrage

Here are Minister Nicola Roxon’s speech notes to a round-table meeting in Melbourne this morning where various groups expressed their upset about the Government’s changes to the process of listing medicines on the Pharmaceutical Benefits Scheme (PBS). As you’ve no doubt heard, the Government has also deferred listing of several medicines that had been recommended for listing by the Pharmaceutical Benefits Advisory Committee (PBAC).

The Government, it seems, stands universally condemned. After the meeting, one of the participants, Dr Ken Harvey, observed that the Government had managed to create something of an “unholy alliance” – between the pharmaceutical industry, consumer lobby and health professions. (For more details, see this joint press release from the Consumers Health Forum and Medicines Australia )

But Roxon makes what seems a fair enough point: that Government must weigh up competing demands for public spending – is it better to fund the continuation of the bowel cancer screening program than new medicines, for example? No doubt many people will respond that we should be able to have both, that it shouldn’t be an either/or scenario. But there is an opportunity cost to every spend.

The previous PBS listing system (with only those above a certain cost going to Cabinet for approval) in many ways privileged medicines over other health interventions. I’m not aware of any mechanism, for example, to ensure the automatic implementation of social interventions that are of proven benefit to a population’s health.

Let’s not forget the recommendation from the National Health and Hospitals Reform Commission report for a common national approach to evaluating all health interventions, with consistent evaluation of medical care, pharmaceuticals, prevention and population health interventions, medical devices and prostheses, allied health and complementary medicine.

As the report said (P97): “To use an example this might allow comparison of the relative efficacy of a medical intervention (gastric bypass), a pharmaceutical intervention (an anti-obesity drug), an allied health intervention (a structured program of exercises and diet management) and a population health intervention (a community walking program) in reducing obesity.”

It would be interesting to see a list of  interventions of proven health benefit (that are not medicines) which are not being funded or provided from the public purse. I doubt it would be a short list.

Whatever the rights or wrongs of the Government’s tough-on-drugs approach, Ken Harvey is sure it will have a heavy political cost (this moving personal story from a person with multiple sclerosis in today’s Crikey bulletin helps explain why – and we can expect to see plenty more such stories.)

Harvey said: “Nicola is a good minister in a hard job and she’s obviously under a lot of pressure from Cabinet and Treasury but I don’t think it will do them any good politically. Politically, drugs are one of the most visible aspects of health policy in every country, and the PBS is the most cherished institution in Australia and to start slicing the recommendations of an independent committee, no matter how justified on the Government’s grounds, is politically dangerous.”

***

For more on the issue

An ABC report on today’s meeting

The Health Report (from Monday)

Dr David More’s blog

***
Update: This was the brief backgrounder from the Parliamentary Library’s FlagPost blog ahead of the meeting:

Rebecca de Boer writes:

This morning (Friday), Minister Roxon is meeting with peak lobby groups about the recent decision by Government to defer the listing of pharmaceuticals on the PBS. Representatives from Medicines Australia, the Consumers Health Forum, the Australian Medical Association and the Generic Industry Medicines Association have invited the Minister, as well as Minister Wong and Treasurer Swan, to explain the Government’s rationale for this approach. Minister Roxon has previously argued that it is the role of the government to provide health for patients across a range of services and to carefully examine the financial implications of each potential new product to be listed on the PBS.

In contrast, Medicines Australia has suggested that the recent PBS growth figures show that growth in PBS expenditure has slowed to 2.8% in the year to March 2011 and that the recent reforms implemented by the Government are achieving their objective. All stakeholders have raised concerns about access to medicines and the undermining of the role of the Pharmaceutical Benefits Advisory Committee (PBAC).

***
Update (May 2)

Bowel Cancer Australia’s response to Minister Roxon’s “nonsensical” comments.

Related Posts

Comments 8

  1. botswana bob says:

    The Advisory Committee is made up of experts with international reputations who weigh up both the effectiveness and the cost-benefit of drugs submitted for PBS listing. It is not easy to get a medication listed as the process is extremely rigorous.
    Now approval is in the hands of those pampered grubs the pollies. This is the mob that will tell you black is white in the morning and come the afternoon tell you black is indeed black and deny under oath they ever said it was white. Pollies have done this before. Under Nelson’s tenure as Education Minister grants approved by the ARC were submitted to a far right ranter from that sheltered workshop at THE AUSTRALIAN and several recommended by international experts in the field were denied funding. This is what happens when trolls like ROXON meddle in findings of their scientific advisers.
    As someone with a chronic health condition, Roxon is among the worst Health Ministers I have seen. She fails to index Medicare benefits–the fee for a GP visit was indexed at half the inflation rate–denies eye surgery benefits to pensioners and in Parliament gives the impression she is the only pollie in Australia who can strut sitting down. An outstanding member of the ALP–Another Liberal Party.

  2. ron batagol says:

    Croakey wrote “The previous PBS listing system (with only those above a certain cost going to Cabinet for approval) in many ways privileged medicines over other health interventions.”

    How many other “competing” health interventions have an Group of expert practitioners in the field, backed up by the professional expertise of the Federal Department, which carry out a detailed analysis ( in this case in pharmaco-economic and quality of life terms), of the cost-benefits of new treatments, including measuring them against existing therapies, as well as a projection of anticipated costs to the Budget, and all that taking place AFTER they have already screwed down and locked into place the prices that the manufacturers and distributors charge?

    So now we have pollies sitting around the Cabinet table, who have no expertise in health matters, acting in a positively anal retentive manner as quasi- experts on pharmaco-economics, ignoring their expert advice and, instead, micro-managing the PBS Budget whilst denying patients the benefit of potentially life-saving medicines recommended for PBS Subsidy by their own appointed expert advisers!

    Remember, this is the same mob that thinks it makes sense to build new bricks and mortar in order to achieve “super” clinics, instead of the obvious alternative strategies, such as expanding existing medical clinics to accommodate other health professionals on existing sites , and investing in upskilling GPs. This could, for instance include incentives for annual re-training sessions in Emergency Departments and incorporating some para-medic activities at selected clinics, to maintain care of chronically ill patients within the community setting. But why are we not surprised at their lack of judgement when we get the ludicrous situation of a proposed e-Health Plan which allows will have obvious gaps in the medical and treatment profiles and allows patients to cherry- pick which records may be included!

    Ron Batagol

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alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013