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Health technology assessment and pharmacoeconomic evaluation were the key pillars of PBS decision-making for several decades but other factors are now playing a significant role in determining what medicines make it onto the PBS.

Dr David Thompson, editor of Value and Outcome Spotlight, asks whether the emergence of gene therapies and cancer immunotherapies has exposed "critical limitations in the tools and techniques" of health technology assessment.

PharmaDispatch asked the Department of Health about the use of 'opportunity cost in PBS decision-making. This is the unedited response.

A new report produced by MTPConnect and launched at the recent BIO international convention in Philadelphia has highlighted the importance of global life science companies in nurturing and supporting the growth of Australia's sector.

Has the PBAC voluntarily adopted its own version of opportunity cost in its decision-making? Or, has it been at the direction of government? It may not matter - the outcome is the same because 'opportunity cost' is just the rhetorical form of rationing.

Advances in DNA sequencing, tissue engineering, cellular reprogramming and gene editing could make it possible to accurately predict an individual's risk of disease or better target treatment at an existing disease.

Why is 'opportunity cost' not applied to other parts of health spending? What about the extra $30 billion the federal government will invest in public hospitals between 2020 and 2025 or the projected increase in spending on Medicare? Does anyone question the 'opportunity cost' of a GP treating an extra 20 patients?

Australia played a leading role watering down a resolution at the recent World Health Assembly that may have required the international sharing of confidential net PBS prices.

The recent push for a 'transparency' resolution at the World Health Assembly appears to have forced Australia to take a partial stand in defence of confidential prices.

According to the former PBAC member, "Being on the committee and looking at opportunity costs has really opened my eyes to that – if you fund this [treatment or medication] you can’t fund that, you really have to prioritise."

Merck employees have taken a first look at their new office with an advance tour of the Macquarie Park site that will become the company's home later this year.

MSD's Michael Azrak discussed industry's approach to a review of National Medicines Policy, supply chain payment refrom and the importance of special pricing arrangements to patient access.