Helen Polley (Tasmania, Australian Labor Party) Share this | Hansard source

Government senators have considered the majority report of the Finance and Public Administration References Committee on the administration of the Pharmaceutical Bene­fits Scheme and disagree with its findings. The evidence taken during the inquiry does not support the position that the govern­ment's decision to defer the listing of certain medicines under the Pharmaceutical Benefits Scheme is a major change in government policy or will have a serious detrimental effect on the PBS, as noted by Professor Lloyd Sansom AO, Chair of the Pharmaceut­ical Benefits Advisory Committee. Before I go on to quote him, I would like to formally thank him here, in the chamber, for his services, as I understand he will be retiring from that position. Professor Sansom said:

Governments have also accepted other PBAC recommen­dations, such as price reductions for biological disease-modifying antirheumatic drugs listed on the PBS for the treatment of rheumatoid arthritis and recommendations that certain medicines should comprise therapeutic groups. ... Previous governments have decided not to accept other recommendations of the PBAC. For example, the recommendation of the PBAC in 2001 to maintain the price relativity between the ACE-inhibitor class of drugs and ATRA class of drugs.

The government of the day sometimes accepts recom­mendations of the Pharmaceut­ical Benefits Advisory Committee and sometimes it does not. The contention that somehow this 'constitutes a major, unnecess­ary and unwelcome change in Government policy' is not borne out. Professor Sansom said that advisory committees 'advise gov­ernments, and we have a democracy where governments make decisions'. But coalition senators continue to put the following view:

This profound and ill-considered change in policy puts at risk affordable access to medicines for Australians, and will have significant consequences for the pharmaceutical sector, including research and development.

What did the industry say? Mr John Latham of Pfizer echoed these sentiments:

When you look at the role of the pharmaceutical industry and what we do, our role is really to innovate and work in a system that discovers and brings new medicines to market. Those medicines are there to treat diseases. For critics to say that the industry are threatening to not bring new products to Australia because we do not like the system is rubbish. We are here and our job is to discover medicines and bring them to citizens around the world.

Yet the coalition senators continue in their view:

Further, the committee is concerned that the independence and reputation of the PBAC will be irreversibly damaged by the referral of all listings for Cabinet consideration.

But Mr David Learmonth, Deputy Secretary of the Department of Health and Ageing, said:

Companies are still actively seeking listing on the PBS, as evidenced by the fact that there has been no change in the total number of submissions received for consideration by the PBAC over the last three months. On the contrary, the July meeting of the PBAC received a record number of submissions.

Besides, the coalition senators have ignored that the number of deferrals is very small and will not impact upon the overall operations the Pharmaceutical Benefits Scheme. The deputy secretary went on to say:

Finally, whilst eight deferrals were announced in February this year, two of these have subsequently been listed. No medicines recommended by the PBAC, at its March 2011 meeting, were deferred by the government and, by September this year, 152 new drugs or amendments to listings of existing drugs will have been listed on the PBS, reflecting the government's continued commitment to list medicines.

The coalition continued:

The government has made much of the need to be fiscally responsible in the current economic climate.

Various witnesses concurred that fiscal responsibility was an important consideration for the government. Mrs Liliana Bulfone from Deakin University said:

In a perfect world there would be no need for a cabinet review of the PBAC decisions, but we acknowledge that affordability of medications in the short term is definitely an issue that the government may need to consider, particularly in circumstances where the drug has an effect over a very long time horizon.

Professor Sansom said:

... there will always be some patients who will not have access to a particular medicine under the PBS, as it is not sustainable to list every single medicine.

Finally, the Deputy Secretary of the Department of Health and Ageing concluded:

I would argue that the biggest hurdle for a company as to whether a drug ends up being subsidised on the PBS remains the PBAC, the Pharmaceutical Benefits Advisory Committee.

And:

In 2010, 63 per cent of all first-time, cost-effective submissions were rejected by the PBAC. This is not a one-off statistic but a consistent marker of the rigour of the assessment process undertaken. It is this assessment process which I would suggest is the main decision point for companies in determining whether to bring a drug to the subsidised market in Australia.

This inquiry did not conclude that the Pharmaceutical Benefits Scheme was seriously harmed. It did not conclude that industry would withdraw from the Australian market. The inquiry did not conclude that the government should not be fiscally responsible, nor should it and nor has it ever rubber stamped the Pharmaceutical Benefits Advisory Committee's recommendations and it did not conclude that the memorandum of understanding with Medicines Australia had been undermined.