What does it say about the state of reform that a recent 18-month process has delivered a report to the health minister probably focused on process and technical inputs to health technology assessment?
Speaking at last week's BioPharmaDispatch conference, the former head of the Department of the Prime Minister and Cabinet, Dr Ian Watt AC, discussed the drivers of reform dating back to the 1980s.
Dr Watt discussed the significant economic and tax reforms of the Hawke, Keating and Howard Governments, identifying political leadership as the trigger and critical ingredient.
He also highlighted the current push to decarbonise the economy as an example of political leadership driving reforms.
Dr Watt said this political leadership forces the wider government and bureaucracy to move in support of the reform ambition.
Can anyone point to clear policy leadership on reforming Australia's existing arrangements for funding new health technologies?
Is the Health Technology Assessment Review and its focus on technical inputs to decision-making what you get in the absence of policy clarity from Australia's political leadership?
Only time will tell.
In May last year, Health Minister Mark Butler described Australia's application of HTA as "clunky" and acknowledged as a "fact" that people are dying waiting for access to new health technologies.
One year later, the product triggering Mr Butler's statement remains unfunded and not even recommended.
Is it a case of the HTA institution ignoring its minister? Or was the minister's excoriation of the institution a one-off aberration? Was it a mistake?
Speaking at the BPD Conference, Boehringer Ingelheim's Dirk Otto lamented the absence of leadership driving reform, as described by Dr Watt, while Bristol Myers Squibb's Owen Smith said his initial observation is that the policy discussion in Australia is caught in the weeds of discount rates and utilities.
Mr Smith articulated a more positive perspective. Fair enough. It can be lost in the weeds that the Government adds around $60 million in new listings to the PBS every month. What other federal program has a guaranteed path to funding?
Of course, we can always do better, but Mr Otto and Mr Smith are right to highlight the transactional nature of the policy discussion for a program that enjoys favoured status.
Dr Watt also repeated comments by Shadow Health Minister Senator Anne Ruston that ministers and stakeholders need to 'buy reform'. He said the industry needs to start preparing for that discussion in the context of Australia's deteriorating fiscal position.
It was a point reiterated by BioMarin's Dr Kathryn Evans. Novartis' Matt Zeller and Viatris' Sylvain Vigneault urged the industry to lead an honest discussion about how we make the system better for Australian patients.
Medicines Australia chief executive Liz de Somer acknowledged this reality and said the industry is preparing for all scenarios. Biolsimilar sector leaders Hayley Tamborini and Clint Holland highlighted the distance between the status quo and good policy.
What lessons do these discussions provide?
Is political and policy leadership setting the imperative for reform, and is the industry prepared for an honest discussion about how it would be delivered?
Time will tell on both.
