Australia’s debate about healthcare policy and access to medicines has long been dominated by technical arguments, but Owen Smith, Vice President and General Manager of Bristol Myers Squibb Australia and New Zealand, argues that the country is missing the central issue.
His message is clear and direct. “You’ve got to have a coherent policy end to end, joined up with a clear coordinated objective,” he told BPDInsights. Without a national life sciences strategy, he argues, Australia will continue to drift, constrained by fragmented policy and short-term thinking rather than guided by a clear sense of national purpose.
The latest policy review has put that problem in stark terms, Smith says.
The 'Ambitious Australia' report, the culmination of the Strategic Examination of R&D, provides an honest diagnosis. It concludes that the nation’s research and innovation system is fragmented, risk-averse, chronically underfunded, and spread across more than 150 programs to the point where it struggles to achieve impact at scale.
For Smith, this diagnosis is accurate and overdue. “At the moment, ours is disaggregated, thin, and ineffective,” he says, arguing that Australia needs a strategy that spans research, development, and commercialisation rather than treating them as separate domains.
Compared with other advanced economies, Australia stands out for its lack of a coordinated life sciences strategy. Countries such as the United Kingdom, Denmark, and Ireland have built integrated approaches that connect research, commercialisation, and patient access. “You’d be hard pressed to think of a modern economy anywhere in the world that doesn’t have a life sciences strategy,” Smith says. "In Australia, this connection has not been made with the same clarity or consistency."
Part of the explanation lies in history. For decades, Australian policymakers have been wary of sector-specific industrial strategies, influenced by concerns about governments picking winners. While this caution may once have been justified, it has left Australia out of step with global trends. It is now increasingly unusual for a modern economy not to have a dedicated life sciences strategy. The result is a system that remains fragmented and less effective than it could be.
The consequences of this fragmentation are becoming more visible. Australian biotechnology companies often take their innovations overseas once they reach late-stage development. Global pharmaceutical companies continue to invest in Australian clinical trials because of the strength of the science and the efficiency of the system, yet they frequently choose other markets for a commercial launch. Patients experience delays in access to new therapies, and fewer treatments are introduced compared with similar countries. At the same time, Australia maintains some of the lowest prices for innovative medicines in the world, reflecting deliberate policy choices.
This combination of factors has created, as Smith describes, a fundamentally limited model. “We’ve got a transactional, low-grade purchaser and supplier relationship,” he says, warning that this stands in contrast to the “high value, highly interactive, highly productive relationship” being pursued in other countries.
The public conversation in Australia also tends to emphasise manufacturing as a key objective, even though it represents only one part of the life sciences value chain and is not the most economically significant. The greatest value lies in research and development, clinical trials, and the networks of collaboration that connect different parts of the global ecosystem. These are areas where Australia already has genuine strengths. The country’s clinical trial sector, Smith says, is highly regarded internationally and consistently delivers strong results in patient recruitment and data quality.
Despite these advantages, Australia has not fully capitalised on its position. The challenge is not a lack of capability but a lack of coordination and ambition. “We in Australia seem to become slightly stuck on a notion that we can’t do that,” Smith says, referring to the idea that the country is too small or too distant to compete globally. “We can’t compete, the size of our market versus other markets is too small.” Yet, he notes, other economies of comparable scale have reached very different conclusions.
The problem is compounded by a focus on technical detail at the expense of strategy. “Those things are symptoms of the disease. They’re not the cause,” Smith says, referring to debates about comparators, discount rates, and pricing mechanisms that dominate policy market access discussions.
The debate over new treatments for chronic conditions illustrates this tension. Emerging therapies with the potential to transform public health and improve workforce participation are often assessed primarily through the lens of short-term budget impact. This approach overlooks the longer-term benefits that could flow from improved health outcomes, Smith says, including increased productivity and reduced burden on the healthcare system.
“You’ve got to think big and macro and long term and in aggregate and not in silos,” he says, framing health investment as a driver of national productivity rather than a narrow budget line item.
One of the most important recommendations in the new report is the creation of a national life sciences council supported by a clear strategic vision. “The number one pillar you should have in any advanced economy is a health and medical science research, commercial competitiveness, strategy and a governance structure,” Smith says, pointing to the need for formal coordination across the system. This aligns with proposals to establish a national council that can bring together government, industry, and research institutions to set direction and ensure accountability.
Such a strategy would need to encompass the full spectrum of the life sciences ecosystem. It would link research funding to commercialisation pathways, support partnerships between universities and industry, and ensure patients have timely access to new treatments. It would also recognise the increasingly interconnected nature of the sector, where innovation often emerges from collaborations that span multiple organisations and countries.
For the industry, there is also an opportunity to change how the case is presented. Smith says arguments that focus narrowly on pricing or individual products are unlikely to resonate with policymakers. A broader narrative is required, one that emphasises the national benefits of a strong life sciences sector. Health improvements, economic growth, job creation, and global competitiveness are all part of the same story, and they need to be articulated as such.
Australia has many of the elements needed to succeed. It has strong research institutions, a capable workforce, and a track record of scientific achievement. What it lacks is the unifying vision that Smith argues is essential. A coherent national life sciences strategy would bring these strengths together, align policy with ambition, and position Australia to compete in a global market that is only becoming more important. Without that strategic intent, the system risks remaining fragmented and reactive. As Smith puts it, “You’ve got to believe it.”
