Pharmaceutical Benefits Scheme becoming unsustainable, says Senate committee – The Guardian

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A Senate committee has called on the government to undertake a comprehensive review of its system for subsidising medicines to taxpayers, as the increasing number of new and expensive drugs being listed on the Pharmaceutical Benefits Scheme is becoming unsustainable.

Australia has the highest incidence of cancer in the world, and with more than 1,000 cancer medicines subsidised by the scheme, the community affairs references committee has been examining how to keep these drugs affordable and available to patients in the face of growing costs to the government.

Cancer medicines account for one in every six dollars expended through the Scheme, up from one in eight dollars in 2012-13. But questions have been raised about the processes used by the Pharmaceutical Benefits Advisory Committee (PBAC) in making its recommendations to the scheme about which drugs to subsidise.

Australia has the highest incidence of cancer in the world

The committee’s report, published on Friday, also recommended a review of the way cancer medicines data is collected, and for the PBAC to make cancer drug submissions publicly available so community discussion of the real benefits, harms and cost of drugs could occur.

While Australia has some of the best cancer survival outcomes in the world, this depends on timely and affordable access to new and innovative cancer medicines through subsidisation by the government.

However, there were “real challenges in establishing the evidence to support the high costs for many of these medicines, especially when benefits are incremental,” the committee report found.

“The pricing of new cancer therapies should also be more closely aligned to their patient outcomes,” the report said.

“There have been few ‘transformative’ cancer medicines in recent years and there is a risk to innovation if business models continue to focus on the financial rewards associated with ‘me-too’ medicines, and not significant innovation.”

An oncologist and co-chair of the Cancer Drugs Alliance, Professor John Zalcberg, called on the government to adopt the recommendations of the report as a matter of urgency.

“We have known for a long time that timely and affordable access to cancer medicines poses a significant challenge here, and we must work together to make our system more equitable,” he said.

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“Until we have a truly modern, responsive and efficient reimbursement system, Australian patients and their families will continue to suffer. Australian patients must be front and centre in any decisions – including funding – that affect access to cancer medicines through the PBS.”

But the CEO of the Consumers Health Forum of Australia, Leanne Wells, said it was disappointing the report’s main recommendation was another government review.

“With over 200 submissions received from organisations and everyday Australians who deal with this issue every day, we were expecting a more tangible outcome,” she said.

“The areas that have been highlighted for a government review have already undergone scrutiny, with recommendations made or pending to government.”

The report also recommended the government examine all available pathways for accelerating the registration and listing of new medicines, including using assessments performed by overseas regulators.