Health Minister Mark Butler has effectively endorsed industry criticism of PBS decision-making during a radio interview Monday, citing Australia's 'old' HTA system as responsible and expressing sorrow over long waits for patients wanting funded access to new medicines.
During the interview with 4BC's Peter Fegan, Minister Butler was asked to apologise to patients who had been waiting an average of 466 days for funded access to new medicines.
"It's too long. I've said that very clearly. It was 466 days when the last government was in office, too. It's not something that's particularly emerged over the last couple of years since we've been in office. But both of us, I think, have said there's got to be a better system. We have a system of assessing and then approving medicines for payment under the PBS that's pretty old. It's been around for some decades. It served us very well, but it's not really working for the scale and the complexity of medicines that are coming to market today," he said.
"I think if there are patients out there who are waiting for medicines to be approved and who are either paying top dollar for them or even worse, might not be getting the therapies that they wanted and need it and to that extent, as the Health Minister, of course, I am sorry for that. We want the system to work better but this is something that has sort of happened over time as the nature of medicines has really changed."
The recent controversy sparked by PhRMA's submission to the United States Trade Representative's Special 301 process identified delays between regulatory approval and reimbursement as one of the industry's primary concerns, pointing to the potential for reform of Australia health technology assessment processes.
The minister pointed to the Health Technology Assessment Review and its implementation advisory group.
"I've got a group now with patient groups and industry groups chaired by a very eminent person who's been involved in medicines for a long time, working right now through those recommendations, trying to prioritise them for government because these are big decisions," he said. "They're going to cost taxpayers a lot of money. Some of them might be seen as more important than others. I want to get a sense of that from patient groups as well as from industry where should we start in this incredibly complex process. But where we can all agree, is that average of 466 days is too long."
Minister Butler highlighted the potential cost of implementing the recommendations, including the proposed 'bridging' fund for specific medicines that meet certain criteria.
"Taxpayers would put in half a billion or $1 billion into fund medicines before they'd been approved. And if they were approved, well, that was fine. And if they were not approved, well, it would essentially be a loss that taxpayers made on a medicine that they bet on that ultimately didn't square up to all of the conditions. Now, this is a fund that operates in some other countries. It's been quite hard to implement in countries," he said.
"But there are different views within the sector among different companies and patient groups about whether that's the best way to go or whether we should just focus on speeding up approvals. And if we speed up approvals, we don't need a bridging fund. That's just one example of a debate within the sector. We want to get to the bottom of that. And so when we make decisions about what a system, which I hope is going to last for the next 30 years, that we get it right," said Minister Butler.
