A Stable, Sustainable and Strong PBS:
Needed now more than ever in a
rapidly changing healthcare landscape
The Future of Medicare
13 August 2014
Elizabeth De Somer
Director, Policy & Advocacy
Medicines Australia
1
PBS role in healthcare
• The PBS has been a key driver in increasing Australians’ life
expectancy over the past 65 years
2
The PBS is sustainable
3
• PBS spending fell by 3.5%, or $356M in 2012-13
• Another drop of $537M is estimated for 2013-14
The PBS is sustainable
4
• PBS spending as a percentage of the Health
budget is in long-term decline
There have been repeated downward revisions of PBS expenditure over recent years
PBS expenditure in decline
5
The PBS is sustainable
6
• Australia is behind the OECD in medicines spending
Reasons for Reform
Where Australia ranks
7
Country Innovation profile (NCEs launched vs. Market Share achieved)
EU average 2.3%
NCEs=82
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
3.5%
4.0%
4.5%
5.0%
5.5%
6.0%
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90
NC
Es (
2008
-12)
Mark
et
Sh
are
of
To
tal R
X m
ark
et
Number of NCEs (2008-12) launched
New Zealand
Australia UK
Switzerland
SwedenSpain
Slovenia
Slovakia
Romania
Portugal
Poland
Netherlands
Luxembourg
LithuaniaLatvia
Italy
Ireland
Hungary
Greece
Germany
France Finland
Estonia
Czech R.
Bulgaria
Belgium
Austria
Norway
EU average n46
Paths of reform
8
Reasons for Reform
9
Source: M Wonder, Development of Industry
Relevant Key Performance Indicators for the
Pharmaceutical Benefits Scheme (2010-2013)
Report prepared for Medicines Australia, May
2014
Reasons for Reform
10
Source: Cheema, P. 2010 “International variability in the reimbursement of cancer drugs by publically funded drug programs”, Medical Oncology, v. 19, n. 3, http://www.current-oncology.com/index.php/oncology/article/view/946/924 (accessed 4/10/2013 )
International access to cancer medicines
Reasons for reform
• Australian medicines exports dropped 13.5% last year
11
12
Risks facing Australian patients
0
5
10
15
20
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Nu
mb
er
of
Med
icin
es lis
ted
in
Au
str
alia
Reimbursed in Aus and NZ Medicines that are reimbursed in Aus but not NZ
Source: PBS (Australia), PHARMAC (NZ)
Additional medicines listed for reimbursement in Australia
vs medicines not reimbursed in NZ
The right road of reform
• All access proposals on the table and examined properly
• Innovation rewarded and protected
• Red tape reduction
• Health technology assessment processes improved
• Consider options to diversify medicines funding
13
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