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
The Health Report (from Monday)
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.