Drug subsidy issues out of PBS’ hands - almost

By Dr. Ananya Mandal, MDApr 29 2011

According to Health Minister Nicola Roxon, expensive drugs have never been automatically listed for subsidy and they can't be now when the government controlling expenses. She added that federal Labor has to balance competing priorities in health and every other department.

The government this February had deferred the listing of seven medicines, including treatments for rschizophenia, chronic pain, lung disease and blood clots, for government subsidy through the Pharmaceutical Benefits Scheme (PBS). That was contrary to a recommendation of the expert Pharmaceutical Benefits Advisory Committee (PBAC).

Following this experts from the Medicines Australia, the Consumers Health Forum and the Australian Medical Association will meet Ms Roxon on Friday in Melbourne to urge her to change the government’s stand. The PBAC this week recommended a further seven new drugs for PBS listing. But the health minister says cabinet will consider any recommendation with a financial consequence. “There's never been an automatic process that a recommendation from PBAC means that a drug would be listed on the PBS and the government has no say in it at all…Cabinet has always had the opportunity to approve or not approve a recommendation made by the expert committee,” Ms Roxon said. Earlier however treatments that cost the government less than $10 million a year were automatically approved once considered.

Ms Roxon said on Friday there were alternatives to the drugs whose listing had been deferred earlier this year. “Obviously we did not do that lightly. All I can ask patients to consider is that there are a range of other health needs ... and our government is responsible for providing those as well,” she said.

AMA vice-president Steve Hambleton said the government was sidelining the independent PBAC. “We respect the right of the government to make the decisions about what to fund…But please don't put another barrier above the PBAC,” he said. “These medicines have been recommended by experts to treat patients suffering from colon cancer, multiple sclerosis, cystic fibrosis and other diseases,” Medicines Australia chief Brenadan Shaw said. “The government's own expert committee has said making these medicines available is cost effective, value for money and the right thing to do. I hope cabinet respects those decisions because it's unclear what expertise or experience cabinet ministers have at their disposal to override the decisions of their own expert committee.”

The Consumers Health Forum's Carol Bennet says the Government has politicised the process and it is a false economy. She said the Government is ignoring the advice of independent experts. “The impact on the health system is likely to be far greater than the short-term financial gain that may be made by not listing these drugs…We're concerned because this politicizes what was previously a very good process that had integrity, that had independence from Government, and already takes into account the cost effectiveness of the medications that the PBAC recommends,” she said.

Pharmaceutical companies have warned they could hold back new anti-diabetes drugs and other medicines from the Australian market after federal cabinet's decision. The warning comes as a Canadian study reveals Australia is already lagging the developed world in giving patients access to new drugs, with the nation ranking 20th out of 29 countries in delivering access to cancer medicines.

Drug company Novo Nordisk warned the uncertainty around subsidies “will impair” its ability to bring its range of new anti-diabetic medicines to Australia. “If we don't get certainty we will have to consider the feasibility of any future submissions," Novo Nordisk managing director Peter Soelberg said. Drug companies Amgen and Eli Lilly have told the Medicine industry journal Pharma in Focus that cabinet's new policy would be a hurdle they would take into account before deciding whether to apply for subsidies for new medicines.