Monique Ryan (Kooyong, Independent) Share this | Hansard source

I thank the member for Higgins for drawing attention to this very important issue. We are very lucky in this country to have a national medicines policy which should guarantee all Australians equitable, timely, safe and affordable access to a high-quality, reliable supply of medicines and medicine-related services. Unfortunately, though, the medication system in this country is too complicated. It's too slow and it's insufficiently responsive to the needs of Australians. I would also note that, for many Australians, medications are still too expensive.

Drugs are approved in Australia after having been assessed by the Therapeutic Goods Administration and the Pharmaceutical Benefits Advisory Committee, who together determine the comparative health gain. This assessment includes looking at the magnitude and significance of drugs' effects—their safety, their cost-effectiveness, their affordability in the absence of PBS subsidies, their predicted use in practice if they are licensed, and the financial implications of that use. The process then involves commercial negotiations between the government and the drug suppliers.

It's clear that the TGA and the PBS are not working as well as we need them to. We have chronic shortages of hundreds of medications in this country, including some antibiotics, diabetes medications and HRT. Just this week operations are being cancelled around the country because of a shortage of intravenous saline. In a country surrounded by salt water, we have a shortage of saline! I'm also hearing from palliative care physicians who are frustrated by ongoing shortages of morphine, which are impeding their care of dying patients. This is a system which is not working as well as we need it to or as well as it should.

It is good that this government has passed legislation which has lowered the safety net for medication prices for many Australians. The government has also passed legislation which has enabled 60-day prescriptions of medications, and prescriptions of up to 12 months after a single visit to the GP. That and the limited price increases that we've legislated in this term of parliament are really important measures for the many Australians who are dealing with severe cost-of-living pressures at this point in time, but we also have the fact that we need new medications. It still takes years to get a new medication from initial application to approval in this country. We know that the PBS operates within a finite budget and that the inclusion of new, often expensive medications is a perennial strain on its resources.

While we all appreciate that the government has to ensure value for money in approving and licensing new medications, its systems are often a frustrating barrier to access to new and innovative therapies. Equity of access is a concern, especially for those with rare diseases which often mandate high-cost, low-volume therapies. As a doctor and a medical researcher, I experienced the frustrations of this system for many years, and I felt them along with my patients and their families.

In November 2021 the parliamentary health committee inquiry documented the need for urgent improvement of the health technology environment in Australia. It described how we need greater transparency around medicine approvals and funding, clarity around how we define cost effectiveness and a commitment to consideration of and engagement with alternative models for funding of the system.

A division having been called in the House of Representatives—

Sitting suspended from 12:30 to 12:41

The review into the health technology assessments in this country has now been gathering dust on the minister's desk for some months, and I don't have any confidence its recommendations are going to be enacted in this term of government. It's extremely disappointing and frustrating for all in the sector because we need this government to tell us how it plans to develop specific funding mechanisms and policies supporting the expedited approval of high-cost, low-volume treatments for medical conditions. Clinicians and researchers deserve an improved framework for ongoing health technology assessments, and this should include a commitment to research and development and to greater innovation and adaptability within our regulatory bodies.

The PBS should provide affordable access to essential medicines for all Australians, but its processes are fraught with challenges. Regulatory delays, cost-effectiveness assessments, budget constraints and negotiation complexities all contribute to the difficulties faced by pharmaceutical companies, healthcare providers and patients. We have to address these challenges through streamlined processes, enhanced transparency and flexible approaches to cost-effectiveness. The government needs to ensure our PBS can continue to evolve to meet the evolving needs of all Australians, and we need the government to act now and to demonstrate vision, decisiveness and effectiveness. Australians deserve no less.

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