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Consumer access to pharmaceutical benefits

Speeches in Parliament
Rachel Siewert 24 Nov 2010

Senator SIEWERT (Western Australia)  (5.14 pm)—I present the report of the Community Affairs References Committee on consumer access to pharmaceutical benefits, together with a submission received by the committee.

Senator SIEWERT—I move:  That the Senate take note of the report. This issue was referred to the Community Affairs References Committee on 25 November last year—so almost a year ago. We were asked to look at consumer access to pharmaceutical benefits and the creation of new therapeutic groups through the Pharmaceutical Benefits Scheme, or PBS, and we were asked to look at a range of issues.

We were very busy—the Community Affairs References Committee is a very busy committee—and in June this year we sought an extension to the reporting date of 26 August. Of course, there was another event happening around that time, so everybody was rather busy and we did not get a chance to complete the report. We sought a re-referral from the chamber, after the election so that we could subsequently report, because we thought this was an important issue.

During the inquiry, the main issues raised were around consultation, interchangeability of medicines, exemption from payments of therapeutic group premiums, and the cabinet consideration threshold for higher cost medicines. The committee has made recommendations on each of these issues.

On the consultation issues, concerns were raised regarding the lack of consultation undertaken by the government in the creation of the four new therapeutic groups announced in the 2009 budget and also in the 2009-10 Mid-Year Economic and Fiscal Outlook. The four therapeutic groups were high potency statins and drugs to treat depression, osteoporosis and Paget’s disease.

The committee was concerned about the lack of consultation with consumers, and we have recommended that the government examine ways that there can be greater engagement with consumers in the decisions to create new therapeutic groups. Of course, this is a bit of a moot point now. I should add that the committee has done a lot of PBS work recently, and that is a bit of a moot point in terms of new therapeutic groups because of the passing of the PBS legislation this week.

On interchangeability of medicines, there was quite a discussion. As to the interchangeability of medicines in a therapeutic group, we had quite a bit of discussion. We think it is an important issue, particularly as to the lack of definition around interchangeability on an individual patient basis. In response, the committee has recommended that:

… the Pharmaceutical Benefits Advisory Committee:

• develop agreed principles of what constitutes “interchangeable on an individual patient basis”;

develop criteria by which the “interchangeability” of a medicine will be determined; and
publish both the agreed principles and criteria. We then looked at the exemption from the
payment of therapeutic group premiums. The committee was concerned by evidence from doctors indicating that they were not aware that they were able to request an exemption from payment of a therapeutic group pre

mium on behalf of their patients. This did concern the committee quite a bit, and we have recommended that the Department of Health and Ageing provide regular and ongoing education and information to prescribers to ensure that they are aware of the exemptions and the process for seeking these exemptions on behalf of patients. This is a very important point for patients.

The issue of the threshold for cabinet consideration of high-cost medicines was considered as well. During the inquiry, the innovative pharmaceutical industry and consumer groups called for the threshold for cabinet consideration for high-cost medicines to be increased, because it had not been increased for a significant period of time. The point here is that they can get held up in cabinet for up to nine months. So that was raised as an issue. It was not that we thought that cabinet should not look at these high-cost medicines; it was the time consideration for medicines that are not so high in cost because the threshold has not been increased for a while. So the committee has recommended that the threshold be adjusted initially to the value at which the threshold would have been if it had been annually indexed from 2001. And, to stop this issue happening again, the committee has recommended that the threshold be annually indexed so it is keeping pace with the CPI.

Those are the key recommendations of the committee. I urge the Senate to look at the recommendations and I urge the government to take them on board. I commend the report to the Senate.

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