If the last fortnight has demonstrated anything, it's the challenge of having a considered debate about the PBS in Australia.
In a statement in response to confirmation that pharmaceuticals would be excluded from significant tariffs imposed by the US, Medicines Australia said, "Speculation about the United States (US) Administration’s views on the Pharmaceutical Benefits Scheme (PBS) has reconfirmed the sanctity of the PBS as the cornerstone of Australia’s healthcare system."
It's an unfortunate use of the word 'sanctity' because it essentially legitimises the utterly ridiculous claims levelled at PhRMA and the US industry - that it wants to 'dismantle' the PBS.
It's a surrender.
Medicines Australia knows the claim is ridiculous.
Medicines Australia knows that tariffs on Australia's minimal pharmaceutical exports to the US are irrelevant to the PBS.
Medicines Australia knows that the 'sanctity' of the PBS is not and has never been questioned because of anything PhRMA says or does.
It knows that PhRMA's criticisms of the PBS are based on its own and reflect those of Health Minister Mark Butler.
The association's statement makes no sense other than as an attempt to curry political favour with a Government that has displayed utter contempt for the industry with its false claims of an agenda to dismantle the PBS.
If you're not going to defend the industry against claims it wants to dismantle the PBS and effectively give credence to the conspiracy theories, when would you defend the industry?
Why didn't the association take the opportunity to say, 'We told you so'? The opportunity was to make the obvious point that the exclusion of pharmaceuticals and the absence of any interest in the PBS reflects the united position of the industry, including PhRMA, and Australia's political leadership that reform is needed and necessary and can be driven domestically.
Maybe Medicines Australia believes Australia is incapable of a mature conversation about the PBS.
To be clear, the PBS and its supporting legal framework are non-tariff trade barriers.
Why shy away from this reality, given the public health rationale makes it very defensible?
The Australian Government asserts its role as the monopsony funder of prescription medicines in multiple ways, including regulations limiting private health insurers' ability to expand their coverage.
Please make no mistake: while this approach might be defensible on public health considerations, it's a non-tariff trade barrier. Australia's National Fractionation Agreement, under which CSL is the country's sole plasma fractionator, is another non-tariff trade barrier.
Yet, apparently, in the minds of our political leaders, and potentially some in the industry, even raising these as non-tariff trade barriers represents an assault on the sanctity of the PBS and public health imperatives.
At a media conference yesterday, Minister Butler repeated the falsehood that the US pharmaceutical industry aims to dismantle the PBS.
Why would the industry want to dismantle a program that provides a guaranteed path to funding?
Yes, the industry has gripes with the program, which have been consistently legitimised by Minister Butler's almost identical criticism of Australia's use of health technology assessment.
An obvious retort to Minister Butler might be that he's made the dismantling much easier by appointing Pfizer's most senior executive in Australia to the implementation advisory group, co-developing the Government's response to the Health Technology Assessment Review.
His reference yesterday to the parliamentary debate on the pharmaceutical side letter of the US-Australia Free Trade Agreement (FTA) was also a fantasy.
Minister Butler claimed that the then Labor Opposition acted to ensure the FTA's enabling legislation did not undermine the PBS. Was he referring to the enabling legislation related to patent notification, which would have no material impact on the program?
The politics is understandable, but that doesn't alter the truth, in 2025, the US is more likely to adopt PBS pricing policies than to seek their elimination. Spare me the conspiratorial nonsense.
