"I think when you talk about reform, you can almost say there's reform with a small 'r', and there's reform with a capital 'R'. We are slightly bogged down in reform with a small 'r'," said Boehringer Ingelheim's Dirk Otto.
Mr Otto spoke at the recent BPD Annual Conference as part of a panel with Bristol Myers Squibb's Owen Smith.
"Eventually, the final report of the Health Technology Assessment Review will be published, and we'll work on that. It must be stuck somewhere in Canberra traffic, but we are in the health department, and the minister's office and we need to do all of that. But I think we need a big push for reform with the capital 'R' and we have to break some paradigms on the way," said Mr Otto.
Mr Smith, who has led Bristol Myers Squibb in Australia and New Zealand since January, said that based on his experience of both, the UK and Australian markets share similarities.
"Obviously, they're two of the most sophisticated healthcare systems in the world. They're two of the systems that are probably the longest-established and most sophisticated HTA systems, and a lot of the debate in Australia is very familiar.
"In some ways, it feels to me as though the debate here is a bit behind the UK," said Mr Smith, pointing to the opportunity for Australia to adopt more flexibility and a holistic view of the value medicines provide.
"Some of the changes from the UK's HTA review certainly speak to that. They are less in the weeds about shifting the discount rate or different ways to look at utilities. That's where I think we need to focus in Australia, keep our eyes lifted up.
"The one other thing I'd say is that having sat through a lot of today and had the reports from yesterday, I still think there's so much to be proud of and pleased about the system here in Australia. I think there are so many positives about the system here, as well as the strong and rich history and tradition of partnership between industry and government.
"Sometimes you can look at it as the glass being half empty. I come here with a fresh set of eyes from the UK, where we have our own problems, and I see significant opportunities in Australia for industry and the innovation that we are bringing to the market around the world to really make an impact here for patients. I also see opportunities for us to really partner with the government in ways perhaps we haven't done previously," said Mr Smith.
Mr Otto said the required change would not be achieved through a discussion that was "bogged down" in the process.
"That's not going to crack it. We need to campaign for more health 'bucks' because if we don't manage that, we'll always get drawn back into those discussions about savings. Who's going to finance that reform?"
He said, "We deeply believe we must offset everything within the health budget. Why? I believe that the trick to break through that is to campaign together and help the minister and help the shadow minister in the election campaign to secure more for health."
"The eternal truth is that all change and all good reforms take time to deliver," said Mr Smith. "They don't happen overnight. It's time and dedication and lots of investment to make the case, repeat it, and ensure everybody's convinced of it. And then only sometimes, after as many as 15 years, do you eventually see that everybody's on board and you can move forward.
"The second thing that's required is to make sure that people in government see the need for the change. Often, that only comes when they see a downside," he said.
Looking ahead to 2025, Mr Otto said the industry's goal should be to work with other stakeholders to position health at the centre of the election campaign. "I think if we get our act together now, we can position that more prominently. It won't be easy. We have to work hard now to position health and health investments prominentlymand then we'll have something positive to look back on next year when we're sitting here."
