Comment

Medidata's Alicia Staley has over 20 years of experience in software design and information systems management. She is also a three-time cancer survivor. Over the past ten years, she has applied her engineering background to improve the patient experience for those dealing with cancer, and shares her thoughts on the future of clinical trials.

The Grattan Institute has published some absolute clanger statements about the PBS over the years - their latest is up there with the best.

Few in the biopharmaceutical sector may have read Geoff Summerhayes' speech on private health insurance but it provided further evidence of the increasing policy crossover with industry.

Public Summary Documents contain a lot of information about how the PBAC considers a submission. Yet what about any advice or input from the PBAC Executive.

Advocating for policy change is hard at the best of times. It is even harder when you are the global research-based pharmaceutical industry and arguing for an exception in an area over which there is minimal transparency.

Twice in the same week, we have been presented with the clearest possible evidence of how the new technologies emerging from company pipelines are transforming the industry's relationship with the health system.

When was the last time an Australian health minister announced funding for a new health technology that included a detailed reference to a company's investment in new manufacturing? How about never.

The transparency discussion is undermined by the fixation on outcomes and the focus on publishing information that realistically adds almost nothing to the community's understanding of how medicines are funded in Australia. This fixation is compounded by a power imbalance that sees all the pressure on the industry when it comes to transparency while 'backroom' processes remain a mysterious locked box.

The industry has and continues to be under significant pressure from policy-makers to allow the publication of section eight of the PBAC meeting agenda - pricing matters - but this is one of the few areas of the system over which the industry holds virtually all the power.

The certainty of change is a key lesson of the past decade but another might be the importance of working to lead that change - this might be less about predicting the future and more about making it happen.

Australia consistently claims PBS decision-making is evidence-based. If so, surely utilisation and spending caps should be based on the actual number of patients fitting within the cost-effective prescribing criteria?? This seems an uncontroversial proposition. 

When it comes to realising these benefits, the trap for industry, clinicians and patients is to advocate for change in the context of Australia's existing and outdated approach to health technology assessment.