Fiona Martin (Reid, Liberal Party) Share this | Hansard source

The National Health Amendment (Safety Net Thresholds) Bill 2019 will amend the National Health Act 1953 to implement our election commitment to lower the Pharmaceutical Benefits Scheme, the PBS, safety net thresholds for individuals and their families.

The amendments are needed to implement our 2019 election commitment to reduce the out-of-pocket costs for patients who are accessing PBS medicines. This bill will reduce the PBS safety net threshold amounts for concessional and general patients, and their families, from 1 January 2020. The changes to the safety net threshold amounts will enable PBS patients to reach the safety net earlier in the calendar year. The safety net threshold for concessional patients will be reduced by 20 scripts, from 60 PBS scripts to 48 PBS scripts, at the concessional co-payment level. This will reduce the concessional safety net threshold to an estimated $316.80 in 2020. Without this proposal, the 2020 concessional safety net threshold would have risen to an estimated $396. The safety net threshold for general patients will be reduced from the 2019 threshold of approximately 38 scripts to approximately 36 scripts. Without this proposal, the 2020 general safety net threshold would have risen.

Lower PBS safety net thresholds will benefit up to around 1.6 million concessional patients and 129,000 general patients, allowing them to reach the PBS safety net sooner, reducing their out-of-pocket costs. It will, in particular, improve access to PBS medicines for patients whose treatment requires a larger number of PBS prescriptions each year, such as people with chronic conditions including asthma, diabetes and high cholesterol. Reaching the PBS safety net enables a patient to access PBS medicines either at no cost or at a cheaper price for the rest of the calendar year. The measure will reduce prescription costs, saving the majority of patients approximately $80 per year. Lowering the concessional safety net threshold will benefit the holders of pension concession cards, Australian senior health cards and healthcare cards. It will also provide a benefit for gold, white and orange card holders under the Repatriation Pharmaceutical Benefits Scheme.

The measure to lower the safety net threshold was previously announced by the Prime Minister on 2 May 2019 as an election commitment and, at the time, was welcomed by stakeholders as a positive measure that would benefit patients. The safety net threshold amendment will cost $328.8 million over the current budget and forward estimates. Through the PBS, patients can access medicines that in some cases would cost tens of thousands of dollars per year for a maximum of just $6.50 per script for concession card holders or a maximum of $40.30 for non-concessional patients. Patients receive free or reduced-cost scripts once they reach the safety net. Ninety-one per cent of PBS scripts each year, or 186 million scripts, are dispensed to concession card holders, including pensioners and low-income earners, meaning they pay no more than $6.50 per script for medicines that without a subsidy would cost them much, much more than that. Twenty per cent of scripts for concession card holders, or 37 million scripts, are free of charge because patients have reached the safety net.

Since coming to government in 2013, we have invested $10.6 billion to list over 2,100 new or amended medicines on the Pharmaceutical Benefits Scheme. We are averaging 31 new or amended listings per month—approximately one per day. Many medicines would cost hundreds of thousands of dollars per year and would be out of reach for many, but, through the PBS, general patients will pay $40.30 per script, or $6.50 per script with a concession card. Recent new PBS listings include medicines for lung cancer that were costing patients $88,000 per year; for cystic fibrosis, $300,000 per year; and for arthritis, over $16,000 per year. Recent new PBS listings costing $67 million include Botox, which will have its current PBS listing extended to include adults with lower-limb focal spasticity following a stroke. More than 2,800 patients per year are expected to benefit from this listing. Without the PBS subsidy, patients would pay more than $5,400 per year for this treatment. In August, another key listing was Avastin, for relapsed or refractory glioblastoma. Around 890 patients with relapsed or refractory glioblastoma will benefit each year. Without the PBS subsidy, the $31,200 per course of treatment would have been borne by the patients. Avastin treats brain tumours that are resistant to previous treatment and it is very important to patients with relapsed or refractory glioblastoma.

Sprycel is for acute lymphoblastic leukaemia. The Morrison government is extending the current listing of Sprycel to newly diagnosed patients with Philadelphia chromosome positive acute lymphoblastic leukaemia. Without the PBS subsidy, around 88 patients might pay more than $51,000 each year for this medicine. Through the PBS, they will pay $40.30 or $6.50 per script.

Another treatment listed on the PBS is Actemra. This listing will directly benefit patients who have an inflammatory disease affecting the large blood vessels of the scalp, neck and arms. This charge could benefit an average of 852 patients per year and, without this PBS listing, patients like Alistair would otherwise have paid more than $10,200 for each course of treatment.

In Australia, one in 2,500 babies are born with cystic fibrosis each year. That's one every four days. Sadly, there is currently no cure. Kalydeco has been extended and added to the PBS listing and is now available to patients aged 12 to 24 months with cystic fibrosis. Kalydeco lessens the viscosity of mucous in the lungs, helping patients to breathe more freely. Without the PBS subsidy, patients might pay up to $300,000 per year for this medicine.

Labor stopped listing medicines in 2011 because they could not manage the economy. The 2011-12 portfolio budget statements explained that the listing of some medicines would be deferred 'until fiscal circumstances permit'. This included medicines for chronic obstructive pulmonary disease, endometriosis, IVF and asthma, among others. A strong economy ensures that the Morrison government is able to invest in essential health services. If you can't manage the economy, you can't manage health. The Morrison government's plan for strengthening Australia's world-class health system is providing Australians with access to quality medical care, record hospital funding, affordable life-changing medicines and breakthrough research for new drugs and treatments.

Medicare is funding at record levels. Almost nine out of 10 Australians who visit the doctor have no out-of-pocket costs with their GP. Bulk-billing is at a record rate of 86 per cent, up from 82 per cent under Labor. In my electorate of Reid, 93 per cent of GP visits were bulk-billed last year. That's over a million visits to the doctor in my seat alone. Hospital funding is up 60 per cent since Labor left office in 2013, and the Morrison government is providing an additional $31 billion for hospitals from 2020-21 to 2024-25, to employ more nurses, doctors and specialists, delivering in partnership with the states and territories, and offering more surgeries and medical services. If you can't manage the economy, you can't manage health.

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