Christoph Glaetzer is the chief global value and access officer at Janssen and spoke with BioPharmaDispatch during his current trip to Australia.
Mr Glaetzer has 25 years of experience in health economics and market access in country, regional and global roles.
He told BioPharmaDispatch that his role is connecting the internal innovations of Janssen's pipeline to patients and health systems.
"It's a very interesting time that we live in because science is moving at a pace we have never seen before. We have so many new modalities discovered in the last decade, which now present us with this concept, like bispecific CAR-T therapies, the concept of actually curing a disease, which is fascinating to be part of.
"There has never been a time where more technological change has been brought at a high pace to patients and health systems. Yet we also see some systems still using value frameworks from 30 years ago. We need to work with these systems so they can catch up to the science," said Mr Glaetzer.
Against the backdrop of the current health technology assessment review, Mr Glaetzer said he hopes it will be the "right moment" and opportunity where Australia "has a chance to come back on track where it belongs, to catch up with where science is going and to catch up with where other healthcare systems are going."
"The fact is that Australia is a very well-developed country with high standards in all areas, but it is lagging when it comes to access to innovations, and significantly.
"It is three or five times longer in Australia to get access to an innovation than in the other main markets, notably Europe. Australia is currently behind, and right now, I think it is time to catch up.
"I was interested in the health minister's focus on addressing this. He recently said, ok, patients are dying because we are taking too long on funded access. I think that could be the moment where decision-makers take the opportunity to embrace the need for change and catch up."
Mr Glaetzer said his global perspective had shown him that considering clinical evidence and cost in the same process makes systems less responsive to new technologies and represents a barrier to change.
"If you think about health technology assessment, a big topic in Australia, the countries that separate clinical evaluation from the economic consideration and budget impacts, so the clinical effectiveness markets, as we call them, Germany and France, are faster and quicker in adopting innovations."
He continued, "Regulatory bodies, including in Australia, understand and accept the need to balance issues like uncertainty with speed to access. Payers worldwide are increasingly doing the same thing, and part of that is understanding that the approach to evaluation ten, 20 or 30 years ago might hinder that objective."
"If you think about long-term treatments, for example, CAR-T therapy, you will never be able to show an overall survival quickly, so systems need to understand and accommodate uncertainty, or patients will miss out.
"This is a major moment for Australia. If you do not take this moment, of course, correct, the issue will ultimately become one where the standard of care is increasingly deviating from that in other markets.
"What does this mean? Clinical trial design where comparators are so important. In some countries, clinical trials with new technologies are no longer possible because the standard of care is so far behind. Clinicians will say it is simply inadequate to put a patient on chemotherapy in a clinical trial."
Mr Glaetzer said the almost 500 days between regulatory approval and reimbursement in Australia compared to the 100 days goal adopted by many comparable countries indicates the need for change.
"The opportunity is to take this moment now, a review of methodologies, with a framework commitment to changes that match the superfast development in science. Let's bring this together and work out how to make this happen so Australian patients can access the latest science at the same pace as patients in other countries. Let's not get stuck in endless debates about small methodological calculations."
