Many in the biopharmaceutical industry will remember Senate Estimates from last October during which a senior Department of Health official let slip the government had already budgeted cuts under the new PBS 'pricing framework'.
Yet of equal significance was a subsequent exchange between departmental officials and Green Senator Rachel Siewert.
In a 15-minute exchange, during which Senator Siewert raised questions about the operation of the Opiate Dependence Treatment Program (ODTP), officials appeared confused. They struggled to answer Senator Siewert's questions and confused the ODTP with arrangements for the Staged Supply Program under which medicines are dispensed in instalments to people at risk of drug dependency.
The officials also incorrectly claimed the federal government funds the states and territories to deliver the ODTP.
Senator Siewert eventually became exasperated and said it was hard to ask questions if the officials did not understand their own program.
The officials subsequently came back and clarified their responses but essentially further confused the issue. They claimed the ODTP is "run through the states and territories". Yet around 75 per cent of the program is delivered through community pharmacy on behalf of the Commonwealth, as the PBAC itself has publicly stated.
It appears the Department of Health officials reacted to their experience at Senate Estimates by checking on the ODTP arrangements because within weeks and by the end of November stakeholders were sent a draft 'legislative instrument' for consultation.
The legislative instrument may have appeared in response to legal doubts over the operation of the ODTP under which patients are denied the protection of PBS co-payments and the safety-net. They are forced to pay private dispensing fees that can exceed $200 per month.
The draft instrument, if adopted, will enforce these arrangements. In other words, it will formally remove pharmacy dispensing remuneration and deregulate fees for one group of patients accessing PBS-listed medicines.
Health minister Greg Hunt has said the arrangements can exist in the absence of a legislative instrument. He said an instrument will provide 'transparency and clarity'.
It will also allow for the enforcement of unregulated and uncapped private dispensing fee for some PBS-listed medicines and entrench discriminatory arrangements for one group of Australians.
Rather than moving to address the drastic and undeniably inequitable flaws in this program following their embarrassment at Senate Estimates, Department of Health officials are attempting to quickly move to make this discriminatory program lawful and enforceable. The wider implication is the precedent it sets for the hundreds of other medicines reimbursed through Section 100 of the PBS.
