Comment

How would companies respond if the government confidentially negotiated a change in the PBS with another stakeholder group?

The wider context in 2019 and 2020 will be the apparent return to PBS growth, a significant shortfall in savings, the need to fund new listings and whatever is negotiated as part of the next 7CPA, and a process that deems the reimbursement of some medicines as something other than a priority.

Is industry at risk of backing a system reform that explicitly prioritises the interests of some patients over others? Is it at risk of being in a position where putting patients first actually means putting some or only some patients first?

The industry already has extensive experience with a 'prioritisation' process. Who remembers the 2011 deferrals policy and has any experience with the technical group advising New Zealand's PHARMAC that prioritises every medicine it recommends?

If Labor wins the next election, Catherine King will have many significant decisions to make in her first weeks and months as health minister, including whether to stick with the sector's strategic agreements.

In 2020 will the maker of a new immunotherapy be willing to give up even more of the value of their new hospital administered cancer treatment through statutory price reductions to fund the cost of distributing old and commoditised generic medicines?

This return to growth meant net spending on the PBS in 2017-18 was higher than it is budgeted to be in 2021-22. This is a massive problem for the sector because it means the limited growth over the next four years that was allocated in the 2018-19 Budget is already gone.

Industry confidence in the implementation of the Medicines Australia strategic agreement has fallen to the point there appears to be little enthusiasm for its speculated extension.

Why force Australia to agree to something politically unpopular and with the associated risk it may not navigate the parliamentary approval process? Does anyone think the Trump administration cares about the politics of trade in Australia?

Surely the PBS is an example of the inverse relationship between the extent of an industry's engagement in the political process and its success at securing positive policy outcomes.

NPS MedicineWise is either a government funded business focussed on delivering a key objective of National Medicines Policy or a third-party organisation providing services to both the government and private sector. Can it really be both?

When it comes to advocacy, success is about getting the basics right - keep it simple and bring some energy, act with integrity, be consistent and have 'rules of engagement', engage openly and without overt self-interest on policy, treat others in a courteous and respectful manner, and be honest.