Katie Allen (Higgins, Liberal Party) Share this | Hansard source

I rise to talk on the National Health Amendment (Enhancing the Pharmaceutical Benefits Scheme) Bill 2021. Australians view the Pharmaceutical Benefits Scheme or PBS, as it's known, a bit like the way people in England view the NHS. It is something that people know, that they care about and that they trust, and they want their government to deliver the best PBS possible. That is because every Australian knows that at some point in their life they may have to rely on the PBS, and we know that many millions of Australians currently rely on the PBS. The Pharmaceutical Benefits Scheme serves to give Australians affordable access to quality medicine. It is something that everyone in this House should be proud of. The PBS is being supported by this government but has been supported over many, many years by many, many governments in Australia. Importantly, since this government came to power in 2013, nearly 2,800 new medicines have become available through the PBS. They are all government subsidised to ensure that the health of the citizens of our country is maintained.

The amendments in this bill reflect the new five-year agreements with Medicines Australia and the Generic and Biosimilar Medicines Association. These agreements seek to ensure Australia has a strong supply of medicine, with Australians able to access breakthrough medicines as early as possible. These new agreements that the government and the medicines industry have co-developed as a comprehensive package of reforms for the PBS will ensure that Australians can continue to gain access to new breakthrough medicines as early as possible but also deliver a robust and uninterrupted supply of medicines needed and used every day by Australians. It will just as importantly keep the PBS on a long-term sustainable footing. The industry agreements will achieve this by securing commitments from the medicines industry which will result in new savings from improved statutory price reductions which will be reinvested in the PBS, as they should. This reinvestment will in turn help to make headroom on the PBS for listing new medicines. This is very important because we need to get the balance to enable headroom to be provided so that we can get new drugs onto the PBS.

This bill will see patients save on average due to the decrease in price of a large number of PBS medicines. The reforms are expected to save nearly $2 billion over the five-year remit and will target Commonwealth investment towards securing a strong supply of commonly prescribed medicines that have suffered supply chain issues in recent years. Moreover, this bill guarantees over $5 billion of new investment in PBS medicine listings over the lifetime of the agreements to 2027. It seems like an odd year to say, 2027; it's just around the corner, though! This commitment will help guarantee that the government can list new medicines as recommended by the Pharmaceutical Benefits Advisory Committee as and when they become available and approved.

The bill will reinforce a strong supply chain to ensure that Australians are not left struggling to find the medicines they need. We all know we have been through a pretty dramatic COVID pandemic. Through 2019 and 2020, over 500 medicines listed on the PBS wrestled with medium to critical impact shortages, particularly medicines sold for $4 or less per pack. These were found to be most susceptible to these shortages. This bill seeks to reconcile these issues. The medicines suffering shortages included those that treat depression, schizophrenia, high blood pressure and many more illnesses. Certainly these patients cannot afford to have supply chain interruptions. I know; I have family members affected by some of these conditions. Supply chain interruptions are devastating to those patients. It's important that they can be sure of a secure supply of medicine.

Through COVID last year, I know that there was particularly a supply chain issue of paracetamol, for example. I don't think many people knew some of the struggles that this government had to ensure it dealt with in a pandemic coming at us at speed. It was like being in a great aircraft with both the Spanish flu and the Great Depression coming at us at speed. There were a lot of things that had to be dealt with. The minister for health, the Hon. Greg Hunt, was dealing with some of these supply chain issues himself. I have a constituent in my electorate who is the CEO of Australia's largest generic pharmaceutical company, Arrotex, Dennis Bastos. He called me up and said, 'Katie, I am having trouble with the supply chain of paracetamol as the CEO of one of the largest generic pharmaceutical distributors.' We had to work through DFAT and diplomatic engagement. Finally we actually had to take it right up to the top level, to the prime ministers of both our countries, to solve the supply chain issue with India in order to access paracetamol. Can you imagine the babies of Australia not having access to paracetamol, or the people who are dealing with fever, who are unwell at home, not having access to paracetamol? It was actually quite a critical shortage.

I know there have been many shortages over the last couple of years, and they have been dealt with because the minister for health is very effective at securing supply chains. He gets in front of the problems before they can actually cause problems to patients. We know that he is having to deal with these problems behind the scenes and on behalf of Australians, and legislation such as this will help the minister of the day, in this case Greg Hunt, to deal with supply chain issues.

In order to maintain a strong supply chain in this country, medicines with prices at or below $4 will not have their price reduced under this act. Moreover, medicines with very cheap ex manufacturer price will undergo modest price increases to ensure that manufacturers can secure strong source of supply in the global market. In light of the increased investments by the medicines industry to ensure this strong supply chain, a price reduction floor will be introduced to support the pharmaceutical industry. This is the balancing act that the minister of health needs to do to make sure that we get the best outcome for all Australians and, of course, that the taxpayer's dollar gets well invested. This amendment serves to support low-cost medicines so that these manufacturers can compete in what is a very aggressive global market as well as invest in supply chain resilience. When a PBS listed brand is protected by the price reduction floors previously mentioned, they will be under strict obligation to hold large amounts of stock in Australia. This will ensure the supply chain issues are not damaging to the Australian environment.

This bill acts to employ stockholding requirements, requiring manufacturers to hold at least four months of typical demand of stock on hand. This amendment will almost universally apply to all medicines with prices below $4 to ensure that those struggling in this country with illnesses that are affected by these medicines can rest assured that they will not have their important lifeline of medicine cut by supply issues. The amendments in this bill will ensure sustainable supply for the Australian people of the medicines they need as well as supporting the medicines industry to invest in holding greater stock of medicines most at risk of global shortages and investing in greater supply chain resilience.

Since October 2013, the coalition government has approved approximately 2,800 new or amended medicine listings on the PBS, at an overall investment by the government of $14 billion. This is something that taxpayers should be very proud of—the investment of their funds to make sure that Australians can get access to secure, reliable, highly efficient, highly impactful medicines at a very reasonable cost. The Morrison government has a demonstrated history of support for the PBS. In the 2020-21 budget, nearly $900 million was invested by this government in new and amended listings as part of the scheme. This includes for breakthrough treatments for cancer, depression, eczema, attention deficit hyperactivity disorder, pulmonary arterial hypertension, asthma, migraine and Parkinson's disease, just to name a few.

Notably, a medicinal cannabis product, cannabidiol, is now included on the PBS for use in treating Dravet syndrome, which will save more that 100 Australians and their families over $24,000 a year in costs. This is really important because these children—it is usually children who are affected by Dravet syndrome—often have very difficult lives and do not necessarily have the means to support themselves with this incredibly helpful drug, which makes such a significant difference to their lives and their quality of life.

Further examples of what's being listed on the PBS include ofatumumab. I'm giving the generic name, because it's very important that we list generic drugs. This is listed on the PBS for the treatment of relapsing-remitting multiple sclerosis. I know so many people—family members, friends and patients—who've had multiple sclerosis. It can be a devastating condition. Around 5,000 patients a year will benefit from this listing. Without subsidy, patients could pay $28,000 per year of treatment. You can imagine that someone who's affected by multiple sclerosis may, because of their chronic health condition, not have the employment to be able to afford a treatment that costs $28,000 per year. That's an enormous undertaking, so you can imagine what a relief it is for patients who have relapsing-remitting—meaning it keeps coming back and getting worse—multiple sclerosis to be able to have a treatment that will offer them support and better quality of life. It is indeed something that we should all welcome and feel very proud of.

A further drug, listed from 1 September 2021, is cariprazine—getting the names right can be quite tricky even for a doctor—which is listed for the treatment of schizophrenia. This means that 39,500 people will benefit, each being saved $1,200 per year for treatment. From 1 October 2021—I'm really going to struggle with this—brolucizumab is listed for patients with age related macular degeneration, a terrible chronic eye condition that causes blurred vision or a blind spot in the visual field. People can lose vision, and it can be quite a serious condition. With the listing, 12,800 patients will each save around $8,800 per year for treatment. These are treatments that cost hundreds or thousands of dollars per year, and they could be out of reach for so many, but instead, on the PBS, they will pay $41.30 per script, or $6.60 per script if they have a health concession.

Another drug that has been listed from 1 June 2021 is progesterone, or Oripro, to prevent women going into premature labour, saving around 14,250 women up to $300 per course of treatment. A further drug is lisdexamfetamine, the listing of which has been expanded to include patients who are diagnosed with ADHD after they turn 18 years of age. We know ADHD is a problem that affects so many people, particularly children. As they grow older, if they want to continue to take treatment, around 20,000 patients could access comparable treatment for this condition and could benefit from this new treatment option. Without PBS subsidy, patients might pay $1,200 per year for treatment.

Finally, the listing of ipilimumab will be expanded for use in combination when treating patients with unresectable malignant mesothelioma, which is a lung condition that can occur when people have had unexpected exposure to asbestos. Over 700 patients a year may benefit from this listing. Without the PBS listing, patients might pay around $130,000 per course of treatment, a huge amount of money. It's wonderful that these drugs are available for conditions that affect only a small number of Australians—but it could be any of us. Recently, a family friend picked up some tiles when he was renovating an apartment block and found, to his horror, that there was asbestos underneath these tiles. Hopefully, he hasn't had a harmful exposure, but it was a fright that he got, and obviously you never know when you may get exposed to asbestos. So it's great to know that our medical system and our health system are protecting people and supporting people to protect lives and save lives.

This bill will serve to offer low medicine prices for Australians whilst improving the supply chain that helps Australians get what they need. The Morrison government's commitment to the success of the PBS is clear, with a strong record of new medicines being listed and now this bill being brought forward so that the Australian people can continue to have faith in this government's management of medicines listed on the PBS and so that they can work well, hand in glove, with the pharmaceutical companies and Medicines Australia to ensure a balanced outcome that supports a cost-effective way of ensuring that both supply chain issues and the cost of medicines are kept in check. It is vital that every Australian retain their ability to access medicine. Any shortage is unacceptable as this country strives for a system whereby each and every one of us can access affordable and effective medicine. I commend this bill to the House.

See this speech in context