Comment

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the trap for industry, clinicians and patients is to advocate for change in the context of Australia's existing and outdated approach to health technology assessment.

The reality is that, based on the Department of Health's response to the FoI on discussant presentations, the industry could rightly argue for the complete abolition of Public Summary Documents and against the release of any information they provide in submissions.

The PBS may have been starved of funds this decade but arguing for more in isolation of wider changes is probably an advocacy dead-end.

Health technology assessment can at times have the characteristics of a 'cult'. The language gives it away because a system has been allowed to evolve in which the extension of human life is consistently devalued with the help of nomenclature like 'value' and 'willingness to pay'.

If Australia was starting from scratch and constructing a system based on today's technologies, would it look like the one we have today?

Decision-making on medicines is now subject to a terrible inequity under which rationed access is masked by ridiculous euphemisms like 'value' and 'affordability'.

One emerging feature of the public and not-so-public policy discussion in advance of the formation of the National Medicines Policy working group is emerging stakeholder alignment that Australia's evaluation processes will need to be reformed for cell and gene therapies.

The Australian research-based industry appears set on being a small target ahead of next year's Budget but what does it risk giving away in the process?

Would the policy have been scrapped if the PBAC had been prioritising its recommendations - which, to be clear, is what it is now doing?

If a government's acceptance of the 'conditionality' of PBAC recommendations becomes fact today, which it will unless corrected, what will be the consequences under Mr Hunt's successors? 

The federal government now claims it is bound by the 'conditions' contained in a PBAC recommendation - the Department of Health's written advice to the health minister does not really say that.

It seems an overstatement to suggest the PBAC is 'bullying' companies to accept its recommendations but the committee does have a history when it comes to chronic migraine.