skip to main content
1800 500 258

06 Jan 2015

Senate Inquiry into the PBS

In June 2011, The Senate Finance and Public Administration Committee established an Inquiry into the Government’s administration of the Pharmaceutical Benefits Scheme (PBS).

This Inquiry followed a decision by the Australian Government to change the process for the listing of new medicines on the PBS. Since February 2011, all new medicines have required approval from Federal Cabinet before they can be listed. Previously only medicines with a budget implication of more than $10 million per year required Cabinet approval. Medicines costing less than $10 million were listed on the recommendation of the Pharmaceutical Benefits Advisory Committee (PBAC).

The new process has resulted in a number of medicines being deferred from inclusion on the PBS. Considerable concern was expressed about the new process by many key stakeholders in the health industry, including consumer organisations. BCNA was one of 60 consumer organisations to join with the Consumers Health Forum of Australia to lobby against this change in government policy.

Committee report

The Committee tabled its report on this Inquiry on 17 August 2011. The report made five recommendations, listed below, recommending that the Government revert to the previous process for listing of new medicines on the PBS.

  • Recommendation 1 - The committee recommends that the Government withdraw the statement made on 25 February 2011 regarding the deferral of the listing of new medicines and the new rules applying to listings from that point forward.
  • Recommendation 2 - The committee recommends that the Government retract the statement that PBAC listing recommendations will not be proceeded with until savings are found to offset the costs of listing those medicines under the PBS.
  • Recommendation 3 - The committee recommends that the Government should explicitly state that it rejects any implication that the listing of new medicines requires savings to be made elsewhere in the health portfolio.
  • Recommendation 4 - The Government should restate its commitment to making an explicit decision regarding the listing of new medicines on the PBS within the terms and intent of the Memorandum of Understanding signed with Medicines Australia on 6 May 2010 and re-signed on 28 September 2010.
  • Recommendation 5 - That the Government reinstate the '$10 million rule' so that medicines that have a financial impact of less than $10 million in each year over the forward estimates can be listed on the PBS Schedule by the minister without waiting for Cabinet approval.

PBS campaign outcome

On 30 September 2011, the Prime Minister and Minister for Health and Ageing released a joint statement announcing that the Government had agreed to work with industry and consumer groups over the next twelve months to discuss ways to manage the PBS into the future. The Government committed to not defer any drugs that cost under $10 million a year during that twelve month period.

This means that, for the next twelve months, medicines recommended for listing by the Pharmaceutical Benefits Advisory Committee (PBAC) and that cost less than $10 million a year will be added to the PBS without requiring Cabinet approval.

You can read the statement issued by the Prime Minister and Minister for Health and Ageing on the Department of Health and Ageing website.

BCNA will continue to work with Consumers Health Forum on this issue as it continues its discussions with the Australian Government.

BCNA’s submission

BCNA’s submission to the Inquiry expressed our concerns about the new process for the listing of medicines on the PBS. We believe it:

  • unduly politicises the listing process
  • undermines the work of the Pharmaceutical Benefits Advisory Committee, the expert authority established by the Government to assess and recommend new medicines for the PBS, and
  • is not in the best interests of Australian health consumers, including women with breast cancer.

We expressed concern about the implications of the deferral by Federal Cabinet of new medicines recommended for listing by the PBAC. It results in Australians not being able to access, through the PBS, medicines that are recommended for them as their best treatment options. While no breast cancer medicines have yet been deferred, we are concerned that Cabinet may at some time decide to defer a breast cancer drug. This would result in women having to pay privately for this medicine. Those who could not afford it may go without, even though the medicine had been recommended for them by their health professional.

Our submission addressed four key aspects of the Inquiry’s Terms of Reference:

  • The deferral of listing medicines on the PBS that have been recommended by the Pharmaceutical Benefits Advisory Committee
  • Any consequences for patients of such deferrals
  • The criteria and advice used to determine medicines to be deferred
  • The financial impact on the Commonwealth Budget of deferring the listing of medicines

Our submission reflected our strong position that women with breast cancer should be able to access, through the PBS, the medicines that their health professionals recommend as the best options for them. It is our view that the PBAC is in the best position to determine which medicines should be listed on the PBS, and that its recommendations should be accepted by government. We believe the Australian Government should revert to the previous listing process.

Acknowledgements

BCNA acknowledges and thanks the following BCNA Advocates for their assistance in producing this submission:

  • Geraldine Robertson (ACT)
  • Judith Maher (NSW)
  • Lorraine Woods (Qld)
  • Petrina Burnett (WA)
  • Suzanne Mullen (NSW)

More information