One of the most interesting exchanges at the public hearing of the Senate inquiry into access to cancer medicines was between Senator Richard Di Natale and Professor John Zalcberg OAM.
Senator Di Natale and Professor Zalcberg engaged in a discussion about the process for making PBS funding decisions, particularly the use of health technology assessment.
Professor Zalcberg said there is little doubt Australia has an access problem, going on to call for current regulatory and reimbursement processes to be reformed.
"The current system has served us well but does need to be modernised," he said. "We need to rethink the way PBAC works, in order to expedite access."
Senator Di Natale agreed that there are "huge issues" in how Australia reimburses medicines and that "the system needs to be changed."
However, he questioned what a system that goes beyond the current focus on cost-effectiveness might look like.
In response, Professor Zalcberg said there was no "gold standard approach", but identified the failure to use indirect benefits in evaluations as a particular shortcoming in Australia.
He also suggested cultural issues could be behind access delays, arguing that a Government and PBAC with the right "culture" would ensure current issues are addressed.
On the issue of culture, Professor Zalcberg recounted to the inquiry a recent experience at a conference in Japan, at which a French academic told the conference in response to a discussion about access issues in Australia that, "everybody knows how Australia uses it (health technology assessment), which is to delay access."
