The 'Dispatched' Podcast: Recent Episodes
Daily Dispatch
BioPharmaDispatch - discussing the issues impacting the Australian biopharmaceutical and life sciences sectors with Paul Cross and Felicity McNeill.
In this week’s Dispatched Podcast, we unpack the AI Health Summit and agree it revealed a gap between institutional caution and the real-world pace of its adoption. The practical reality of the proposed ban on genetic testing for life insurance, the self-limiting nature of Australia’s health reform processes, the status quo bias, and the absence of any genuine patient-centred purpose in current settings. We also discuss productivity, a critical roundtable, access inequities and the opportunity to broaden the discussion by not accepting the ‘framing’ of choices.
Reform efforts can struggle because they focus on health systems at their strongest point rather than their weakest. Framing is a pernicious tool used to justify delays and denials. We argue that the uptake of GLP-1 therapies in the US is delivering remarkable results, and that we need to apply the lessons from that experience in Australia, challenging institutional narratives and reframing the public debate to focus on public health benefits.
We discuss what could be a significant policy shift in PBS decision-making, with clinical judgement backed by what is a 'common sense' outcome. It could be a new precedent, but only if all stakeholders demand clarity on the criteria so that it can be applied more broadly. We also reflect on patient advocacy in New Zealand, where access has become a political issue and the focus of a significant discussion at this week's Valuing Life Summit in Wellington.
Has Senate Estimates devolved into an overly polite, time-sliced format that enables waffle, obfuscation, and endless questions taken on notice? Does this reflect weakened scrutiny? The responses provided revealed the truth of review processes, which aim to protect institutional power, blame outsiders for problems, and generally add complexity to existing problems. Few appear willing to say the quiet part out loud.
Listen on Apple or Spotify.
We open by marking Yom Kippur and a frank discussion before pivoting to the US 'MFN' drug-pricing moves, what they could mean for Australia’s PBS, and why institutional rigidity in HTA persists and is worsening. Medical research funding rhetoric versus slow progress in PBS and health technology access, hospital funding and NDIS pressures, and the expansion of pharmacist prescribing, as well as the need for subsidised pharmacy services.
On the Dispatched Podcast this week, we reflect on the erosion of public confidence in health decision-making. Former Victorian Chief Health Officer Brett Sutton’s admission that some COVID-19 measures were not strictly evidence-based highlights the need for a Royal Commission, which would have compelled accountability and helped restore trust.
The discussion then turns to MSAC’s rejection of newborn screening for Pompe disease. Health Minister Mark Butler must intervene, not least because he has previously pledged support to affected families.
Looking abroad, Australia can look to New Zealand’s overhaul of Pharmac, particularly its decision to bring in external leadership and critics. It provides a model for cultural reform. In contrast, Australia’s system is mired in the same conversations among the same insiders.
The podcast closes on the Trump administration’s proposed 'Most Favored Nation' pharmaceutical pricing policy and the new 100 per cent tariff. The Albanese Government, they predicted, would adopt a wait-and-see approach, shaped by a long history of industry warnings about lost access to medicines that rarely materialised.
In this week’s episode, the Medical Services Advisory Committee’s rejection of adding Pompe disease to newborn blood spot screening is condemned. The decision is contemptuous, inhumane, and riddled with fabricated justifications based on made-up terms like 'parental hypervigilance'. Families’ lived experience highlights the devastating cost of delayed diagnosis. The committee ignored evidence, misused language, and hid behind flawed economic models while dismissing patients. Health Minister Mark Butler and the Prime Minister can show moral leadership and finally honour their promises of 'never again'.
Patients should never accept a decision-making framework that requires them to sacrifice themselves for a mythical collective good, which is just the government getting the best deal for itself. More evidence of why we need to know what discussants present to HTA committees, and how they reflect personal opinions and ideologies. Financial results that confirm pharmacy's increasing role as a health destination.
The minister focused on NDIS reform at this week's National Press Club address, suggesting that it is taking up a lot of his time. Implementing the HTA Review will be one side of a two-sided coin. While it might frustrate some, it represents a unique opportunity to secure positive outcomes from an inevitable negotiation.
An update on the Government's travel policy! The opportunity of AI, our own journeys, and why it needs to be embraced and not feared, particularly in healthcare. Productivity and the impact of chronic conditions and another example of why it would be better to target support to those most in need.
Government travel policies make us laugh and laugh. Understanding reforms from the government's perspective is critical to understand how they will evolve over time, and an update that raises more questions than it answers.
A special episode focused on the AbbVie-commissioned survey, revealing firm support for increased investment in medicines and the true extent of patients paying the cost of their prescriptions. What does it mean and what is the opportunity?
Another order on pharmaceutical pricing, but what does it mean? What does the Government's productivity roundtable have in common with the HTA Review? Screening programs that aren't, and a co-payment reduction that puts the safety net further out of reach.
A sense of entitlement that needs to be questioned, Australia is on the list of nine countries to be targeted over pharmaceutical pricing, and the hopeless hypocrisy of allowing a group of disreputable regimes to have a say on this country's response to a pandemic, while fulminating about the US on the PBS.
The opportunity for Australia is to do less deflecting on healthcare affordability and engage in an honest discussion about the genuine challenges confronting many Australians. The debate does not just deflect on affordability.
The ongoing debate regarding the US, the Trump administration's potential tariffs on pharmaceuticals and the PBS is mainly characterised by falsehoods and errors. We discuss our incredible frustration over a debate that is almost entirely disconnected from facts, including the apparent belief that Australia has a vast array of advanced pharmaceutical manufacturing facilities. We also have praise for the Prime Minister following his statements at a media conference today.
We have more health commissioners, including for genomics, and we both hope for a more meaningful discussion on weight loss therapies, the opportunities, access barriers, and their system-changing impact. Telehealth is here to stay, particularly in specific therapeutic areas, while one state has introduced political donations reform that could have a broader impact.
The health department has released its incoming ministerial brief to the reappointed Mark Butler, revealing internal government discussions over the future funding of new PBS listings, and hinting at limiting the implementation of the HTA Review recommendations to a small number of technologies. It also contradicts the claim that new PBS listings take 466 days from TGA registration, suggesting that it actually takes almost 650 days.
In a country as wealthy as Australia, how is it fair or equitable that some can pay for new treatments, while most are forced to wait, while the government uses a laborious multi-year process to negotiate the best deal for itself? We are forced to live with a system that regularly treats human health like a failing business. Are we worth saving? We also live with a system whose underpinning framework is often considered inviolable and virtually unimpeachable.
Adding disability to health in an already full ministerial bandwidth and funding challenges. Trade policy and the PBS, and a presentation on the human consequences of our decision-making. Can a targeted diagnostic screening and the strangest patient case study?
Times
0:00 - 9.45: Adding disability to health in an already full ministerial bandwidth and funding challenges
9.45 - 17:55: Trade policy, the PBS, and managing the risks and opportunities
17:55 - 17:55: About a presentation on the human consequences of our decision-making
37:50 - 44:52: Is it a public health measure or revenue raising?
A busy two weeks with an election and the addition of disability and the NDIS to the health portfolio. What does it mean? The credulous reflex response to comparisons between the US and Australian health systems. Why is denying access and out-of-pocket costs in Australia better than what happens in the US?
What is the balance between building national sovereignty in health and protecting patient safety and community confidence in new technologies? Do we need to be careful? An election brings back memories of 'future' funds past.
The health election debate mainly concerned bulk billing. New bureaucracies are rarely the solution to anything, and the challenge of faster funded access to new health technologies, particularly when advisory committees with power appear opposed. The complexity of weight-loss therapies presents opportunities.
Australia's election is two weeks in, and we're having trouble engaging. How positional power and 'expertism' can be confused and the value of a transparent and open forum.
The industry's 'Faustian bargain' on the 'sanctity' of the PBS, the challenge so many have in being clear about the problem, and why Pathology Australia provides an important lesson. Another wrong political message on newborns, why dentists might be worried, positive news on a critical medicines reform, and kudos to a pharmacy chain for promoting flu vaccines.
US criticism of the PBS is like catnip for some people, they can't resist it, even if it's the same criticism articulated by multiple Australian stakeholders and the health minister. The strange secrecy over the government's review of arrangements for blood supply products and the terrible treatment of a female academic leader.
A total victory for pharmacy with the prime minister's appearance at their showcase annual event. We discuss the confected outrage over US interest in the PBS, which is hardly new, and why the industry needs to lead this debate because its reputation and change agenda are being trashed. Much of what PhRMA is arguing reflects what Health Minister Mark Butler said on Sunday when he announced new women's health listings.
Medicines Australia will be appointing a new chair. To what extent does it matter? The participation model means that the industry might be effectively shackled to the 'change' table rather than having a seat at it. The government has worked it out, constantly increasing the price of participation and limiting exclusionary discussions about change. How does that need to change?
A review of Senate Estimates, with irritating warnings, too much passivity, and passive-aggressive responses (0.00-4.50). Revelations on how oral contraceptives navigated the funding process and the drivers of that outcome (4.51-14.10). We disagree on the role of advisory committees in policymaking (14.10-25.00). The impact of individuals in health policy, how change can have a significant effect, and we disagree again on advisory committees and policy (25.01-39.20). Officials confirmed the HTA-driven go-slow on newborn screening at Senate Estimates (39.20-49.20). The challenge of ensuring equitable access to the newly-reimbursed oral contraceptives, given the need for a new prescription (49.20-55.30) and some worrying new policy announcements (55.30-66.50).
A serious discussion about reforming Australia's use of health technology assessment should start with patient rights and the imposition of new obligations on advisory committees and decision-makers. The signs of institutional capture and the dangers of concessions as the price for participation. Once again, pharmacy sets the standard for advocacy with its consistent argument that out-of-pocket patient costs must be lowered.
A major structural shift in the PBS with the government moving to break a long-held article of faith (00:10-9:30). Why can't we debate HTA using some plain language and straight talking (9:30-20:20)? Research grants about patients that patients can't apply for (20:20-28:30), pathology pushing for more funding (28:30-37:00), essential questions for our public health system (37:00-47:00), and a bad memory of Valentine's Day (47:00-48:30).
Genetics and genomics are the focus of this week's episode. It was a significant week with the release of one organisation's pre-budget submission and a new national framework. Not everyone is happy, but is the criticism fair?
Although the pandemic ended over two years ago, the more we learn about what happened, the more we need the promised Royal Commission.
We return in 2025 with a discussion about our recently published special series on achieving change, arguing for it in a system that treats patients as servile to the government's focus on securing the best deal for itself, moral hazards, and bad excuses.
A government review's six-year-old recommendations led to the decision to fund an unapproved and unapprovable product over an approved medicine. The document is the first in a series that ended with an unprecedented workaround on patient safety and confirms the truism that 'everything happens for a reason'.
International comparisons can work both ways, the incredibly disrespectful and dismissive 'let them eat cake' attitudes of two key advisory committees and a welcome ministerial intervention that should be more broadly applied. We also answer some questions from the audience.
There was quite a bit of eminence this week in the public discussion about access to health technologies. Some personal and wider reflections on the role of prejudice in funding and reimbursement decisions.
We draw a line between some very careful use of language by small 'g' government officials that clearly connects some recent processes and events. It could be a coincidence, but it's remarkable and very convenient. Everything happens for a reason, and words matter.
It's another week of debate over PBS deferrals. Unfortunately, there appears to be an effort to limit public discussion. Given the obvious risk to patients and the implications for the access agenda, which is flailing against the backdrop of deferrals, how does that make sense? It also stands in stark contrast to when cost recovery was introduced.
The health department calls them 'holdover' submissions, but they're deferrals. Its strange language does not change the fact that this situation, decided without consultation, could have negative and long-lasting consequences for the world's second-oldest public health program and, more importantly, patients.
A special edition focused on the disappointing and unacceptable outcome on the proposed simplified and faster process for immunotherapies. The institution has revealed a disturbing attitude to patients shrouded in an ability to deliver change.
After a short break, we are back, and there is a lot to discuss. Recommendations to fund unapproved and unapprovable therapeutic interventions, continued disappointment on newborn screening, and a proposed misinformation law that is significantly based on misinformation and an assumption that the government knows best.
A significant structural change in the PBS, which the Government attempted to blunt with 60-day dispensed quantities, is arguably the main growth driver in spending on the program. We discuss the change, which along with others, represents a major reversal in a decades-long approach to medicines access.
The two-sided coin that is the access debate. The competing narratives that might be confusing Health Minister Mark Butler. Governance is an arcane issue, but it matters, and a different approach could mean a better approach to decision-making and improved outcomes.
It has been a week of red flags on the HTA Review, with the occasional green shoot. We investigate each and discuss how unconscious bias impacts decision-making. The way forward as the process progresses to an implementation phase requires some thought, a different approach and a willingness on behalf of stakeholders to do something that makes them very uncomfortable.
No guessing the focus of this week's discussion, but we have worked to focus on a way forward to manage the many challenges presented by the HTA Review, including the importance of injecting some caution in the public response and understanding that the 'celebratory' tone is a very bad way to start a negotiation.
The health debate is increasingly shifting ahead of the election, mainly to challenging issues, including the fierce debate impacting the private health sector. What does it mean for stakeholders wanting attention in other areas? A welcome decision to widen access to a vaccine, but the postcode lottery remains a reality for patients, including babies.
The Albanese Government used moral suasion to resolve the IV fluid shortage caused by other jurisdictions' poor procurement practices. Health Minister Mark Butler used cautious language on the HTA Review. It was what you would expect, but what does it mean in practice?
Australia is not getting a Senate inquiry on the pandemic. The Albanese Government is amending PBS pricing legislation after the Federal Court confirmed that the interpretation of 'agreements' is meaningless compared to the law. The weekly existence of a health minister reveals the practical challenge of achieving reform.
Surprises have become a regular feature of our systems. A better understanding of the details would eliminate the risk. Great news for an Australian family that has suffered the real consequences of policy failures and one host springs a surprise subject on the other.
Strange policy announcements in Queensland. The HTA Review options paper identified the primary cause of access delays - multiple submissions - and proposed changes to incentivise companies to offer price cuts in return for faster listings. Stakeholders should push for 'sunset clauses' in all legislated changes. We discuss the challenges facing a family trying to access support via the NDIS - and how you might support them - and the incredible advocacy of a small group of women.
Why has everything become so political? Our system of insiders and outsiders when it comes to policy. Can the insiders even recognise the problem? The Government's response to the Disability Royal Commission means major changes are coming, including to health decision-making.
Too many still need to understand the difference between policy and health technology assessment - HTA is an instrument of policy. Stakeholders must also consider their broader responsibility to public health and how decisions in one part of the system flow onto others.
Some parts of an institution face the challenge of avoiding complicity in wrong approaches or repeating and even adopting its exclusionary way of working. It is hard. Yet, acting in the interests of patients can require one part of the institution to act against the others. The industry is facing this challenge.
The combination of political will and trust should be used to help more patients. The poor treatment of a family in Western Australia, the pending departure of one of the greatest advocates for patient access, and the political realignment sending a message to companies.
It was an interesting week with the Government acting based on conscience to ensure access to medicine and an advisory committee losing it in a public statement. We also discuss the inequity between public programs.
Vapes! The parliament backed a ban on retail distribution of the products, but an amendment will make nicotine-containing vapes more accessible via pharmacy, and businesses will respond accordingly. Also, why should other stakeholders be concerned about how this amendment was negotiated?
The new Community Pharmacy Agreement is a remarkable document. We explain why it should be read and the negotiation analysed. We also discuss the draft National Immunisation Strategy, the events in New Zealand, and whether we can extract ourselves from a policy discussion that is mostly about health financing.
It's a 'swear jar' episode we discuss the obsession with health technology assessment, why it is used to guide what is just price negotiation, meaning it takes too long, how decision-makers subordinate patient needs to this negotiation, what the future could look like and how it might get even worse.
Budget Estimates and officials acknowledge the slow uptake of 60-day prescriptions. The 'professionally edited' HTA review final report is with the minister, more evidence of the need to watch the diabetes tender and the need for action to ensure the legitimacy of Australia's new National Immunisation Strategy.
The deeper issue revealed by the failure to consult on Australia's new National Immunisation Strategy. One year on from the health minister's admission that people die waiting for access to health technologies and disappointment for patients in New Zealand.
We discuss the BPD Annual Conference, our favourite speakers and panels, including Pharmacy Guild National President Professor Trent Twomey and Dr Ian Watt AC, and the focus on women's health and New Zealand. Why we should encourage more straight-talking and the connectivity that links so many different parts of the health system.
Rather than dismissing Budget realities, stakeholders could be invited into the Government's confidence and told to prepare for a mature conversation about the challenge of funding the PBS and a serious reform agenda to facilitate faster access to health technologies as Australia enters a period of serious fiscal consolidation.
Patients and pharmacies are the winners, but the Budget raises more questions than it answers, with a large Contingency Reserve and what appears to be a raft of decisions taken but not announced.
Budget week is upon us. We share our experiences working on Budgets and discuss the behind-the-scenes process Governments undertake to develop their major annual set-piece announcement. Budgets have changed over the years with the increasing use of 'hidden' measures - which is why caution is required. Who should be telling who about communicating with patients?
Some important messages and learnings from this week's 'Valuing Life—Medicines Access Summit' in Wellington, with patients and clinicians leading with a straight-talking critique of decision-making that has clearly resonated with New Zealand's political leaders.
The importance of scrutinising claims involving data, particularly regarding health care, and the double standard regarding productivity. Kudos to a company for welcoming a new listing but calling out that it has taken over 650 days since TGA registration. The challenge of social media for vulnerable communities.
The 2024-25 Budget is fast approaching. We discuss what to look for, where to exercise caution, and what to ignore. More examples of where informing is confused with consulting leading to the problematic implementation of reform.
The health department is allowing employees to vote on a new name for its main building. We have some suggestions. Is our health system capable of learning from patient experience and the challenges many severely immunocompromised patients face battling to access treatments and immunisation?
This is a podcast without any mention of that HTA Review! Delegated decision-making is a significant feature of Australia's health system. How can advocacy and any push for change be effective without understanding how delegation works? The reality is that when a minister delegates a decision-making power, they formally remove themselves from the decision.
Where do we start? Last year, the minister described Australia's HTA decision-making as clunky and agreed that it led to unnecessary deaths. How does that admission sit with his latest appointments? We start putting together the pieces of a worrying puzzle and constructing a timeline.
The Albanese Government has committed an additional $3 billion for the new Community Pharmacy Agreement. The details are yet to come, but the statement and confirmed financial commitment reflect a Cabinet-endorsed Budget decision. Health Minister Mark Butler said he would now engage with "other stakeholders with an interest in the pharmacy sector to finalise separate arrangements". What do people think that means? We discuss that process, that the money will probably need to be found, and the underlying anger across pharmacies that has seen one group excluded from this year's APP conference.
We discuss speculation surrounding the new Community Pharmacy Agreement and why successive governments support the framework approaching its 35th year. Community pharmacies are a good partner for the government, and so is the industry, but for a very different reason. We also urge the industry to be true to its stated commitment to patients and publicly explain its concerns about the HTA review options paper.
The industry must be congratulated for firming up its criticism of the HTA Review options paper, and it should start speaking publicly about its concerns. The history and how agreements with the federal government have evolved over time. Another disappointment on newborn screening.
Nothing frustrates an advisory committee more than the word 'advisory'. Why any extended powers will be used to their full extent and not in the way many people would like.
The consultation process for the HTA Review options paper upfront invalidates the input of companies, patients and clinicians with an unprecedented 'declaration' process that defines any relationship or expression of a lived experience as a conflict.
It was not an easy or enjoyable decision, but the stakes are very high for Australian patients, given the apparent risks to the future of funded access to health technologies. We also discuss Senate Estimates, a new argument to excuse non-action on newborn screening, Medicare bulk-billing and teddy bears, and the right to disconnect.
With just nine days remaining for stakeholders to submit their feedback on the Health Technology Assessment Review options paper, patients must have access to all pertinent information.
BioPharmaDispatch interviewed Medicines Australia chief executive and reference committee member Liz de Somer on 31 January. The interview was published on 1 February. Medicines Australia approved all included quotes.
The association now appears reluctant to answer questions about its approach to the review's options paper. This reluctance is compounded by a general lack of transparency and secrecy regarding the conduct of a review that has long-term implications for major Australian public health programs.
The importance of this process to patients goes beyond the needs of any individual or organisation.
To assist patients and other stakeholder groups in providing feedback on the options paper, BioPharmaDispatch is publishing the unedited interview recording, which was on the record, to enable a broader understanding of the discussion and the industry's approach to the review.
You will hear an honest and, at times, uncomfortable discussion about the review that reveals the challenges confronting reference committee members whose contributions are covered by non-disclosure agreements. With just nine days to go, listeners and particularly patients might contemplate whether this 'privileged' secrecy approach to policy-making is appropriate for our public health programs.
We understand that Medicines Australia also recorded the interview and would encourage the association to release their recording. This would confirm the unedited veracity of this recording.
The 'Swiss cheese' theory might explain why history is constantly repeating itself and why action is required to avoid the worst aspects of the proposals in the HTA Review options paper.
We are back for 2024 with no end of issues to discuss, starting with the HTA review options paper and the coincidence of many reviews and processes delivering outcomes just ahead of the May Budget.
Looking ahead, the industry needs to find a framework for challenging the government on its decision-making, and awards that recognise the bad, the ugly and the good in 2023.
Timeline
0:00 - 12:00 - Why the industry needs to find a framework for challenging the government in its decision-making.
Awards
12:00 - 17:00 - 'We definitely seriously want to improve transparency and accountability but just not on this Award'
17:00 - 24:45 - 'The most offensive appearance at a parliamentary inquiry Award'
24:45 - 33:10 - 'The it’s all about patients Award'
33:10 - 36:55 - 'The snatching defeat from the jaws of victory award'
36:55 - 38:33 - 'The own-goal Award'
38:33 - 42:00 - 'The Silence Award'
42:00 - 53:30 - Let’s flip the awards and talk about people who have stood firm on principle and had an impact
53:30 - 57:00 - Finally, what the Government has done well regarding the PBS
More silence on a critical social issue. The report of the NDIS review delivers a range of recommendations, including the adoption of an evidence-based funding framework, but is it practical or even possible? Some interesting comments from NDIS minister Bill Shorten might open the door for advocates of health system reform, a debate that always comes down to a question of health system financing.
We discuss the apparent reluctance to speak out on one important issue. The Government's entirely predictable response to the inquiry on access to new medicines and novel medical technologies, why disappointment is the wrong reaction, and the importance of giving New Zealand's government time to reform Pharmac.
The power of language and the habit governments have of weaponising the word 'sustainable'. How the term has been used to 'gently' justify breaking election commitments and its wider impact on policy development and change.
Some interesting undertones at the Pharmacy Guild's annual parliamentary dinner, a slow start to 60-day dispensing and whether the plan for a new agreement to be in place by 1 March is realistic. The industry is very effective at advocacy, but not in the way it might think or hope, and the weight loss therapies that have system-shaping implications.
Any nominations for the 'It Seemed Like a Good Idea at the Time' award? The opportunity to shift the current strategic alignments that impact decision-making, the challenge of diagnosis and why the existing decision-making framework makes it inevitable.
The 'inner circle' running the HTA review and the obsession with confidentiality. An invitation for the government to launch preemptive action to prevent the publication of information that could meet the 'confidentiality' criteria and the least surprising outcome of 2023.
Strange accounting in the health department's annual report with 'adjustments and notional entries required for presentation only' bumping the PBS spend by $1.2 billion. What does it mean? History matters when it comes to policy, with almost nothing happening that the industry did not negotiate, including the time taken to list recommended medicines. This is why the lessons of history are so important for the industry's leaders.
Genomics and this week's CanForum, at which Rare Cancers Australia hosted several interesting discussions, particularly highlighting the patient experience and the federal government's desultory plan for an 'advisory committee'. Should the result of last weekend's referendum trigger a rethink by organisations that actively supported the proposed change?
We discuss this week's interview with the HTA review reference committee chair and answer your questions, including whether the denigration of a journalist and patients is unique to New Zealand's Pharmac and why annual elections for industry association boards might be a bad idea.
Not all listeners were happy with our suggestion the current health technology assessment review is not the first 'comprehensive' process in the past 30 years. We are answering that question and have produced a list of between 40 and 50 similar processes since 1993. It matters because it provides valuable lessons and demonstrates the connection between a review in 2023 and previous processes.
This week's podcast discusses what history tells us about the pre-conditions for change driven by non-government stakeholders - there are few. Are these pre-conditions evident today, or will another policy process end badly? Importantly, there is a way forward in an exclusionary process shrouded in secrecy, but history counts because it provides all the lessons.
A special week in review recorded in New Zealand with election candidate and former industry executive Todd Stephenson. We were lucky to join Mr Stephenson and ACT leader David Seymour on the campaign trail in Wanaka and Queenstown. We discuss the range of issues impacting the election, including the political and policy focus on Pharmac.
A special guest joins the podcast to discuss the lost opportunity to celebrate a significant anniversary for the PBS and even reshape perceptions of the program. The government has also released its Final Budget Outcome, revealing strong growth in pharmaceutical spending and a problem with invoicing companies for rebates.
The entitlement challenge, secret policy processes, and why they matter. We also discuss why Budget forecasts for PBS spending have minimal use - what matters is the actual spend that reflects the addition of new medicines - and how the combination of events has become an indicator of change.
Two PBS 'demonstrations' in Canberra this week - different tones but the messages were basically the same. The complex period ahead for the PBS is reflected across the health portfolio. The raft of reviews launched by the Albanese Government since its election will start to land containing a raft of recommendations that could trigger fierce fights between stakeholder groups.
What are the wider implications of the negotiation for a new Community Pharmacy Agreement, to take effect on 1 March 2024, and can another secret policy process deliver for patients? Another managed release of information on the international HTA collaboration reveals an additional 'fragment' on its activities.
The 2023 IGR has reinforced the longstanding isolation of Budget investment in health and new therapeutic technologies as 'costs' that must be managed. It has also acknowledged the challenge of forecasting future spending beyond the short term. We discuss how the IGR and its focus on investment in health as a cost will frame the raft of current review processes.
This week's discussion concerns transparency, or the lack of in policy development processes, and how it leads to highly curated outcomes that rarely benefit public health programs and the people they are designed to serve.
We discuss what has been a hectic week, to say the least, where to from here, and the implications against the backdrop of a complex and highly uncertain period ahead.
This week in review is titled 'you can't make this up' as we focus on the lack of transparency and openness on two critical processes and the excuses to justify the secrecy. We also discuss interesting news about the 16 referrals for potential breaches of the APS Code of Conduct following the release of the robodebt royal commission report.
We answer your questions today, with each of us producing our own list of five positive things about the PBS, but also the opportunities for reform.
New Zealand's Pharmac looks forward to sharing its model with counterparts in Australia, the UK and Canada, the parliament is considering new laws that will force one group of families into a very difficult and unfair decision that could have implications for every patient advocate, the government has released its long-awaited 'well-being index', and we answer your questions.
Why should everyone be concerned by the obsession with secrecy over a public health program, the wider lessons from the 'Royal Commission into the Robodebt Scheme', and the reality that a status quo approach to policy change is doomed to fail?
The secret involvement of Pharmac in the international HTA collaboration, why it has no place in any process that could impact patients anywhere in the world, and why industry and patients need to act to urgently block the 'dark arts' spread of its terrible ideas.
Why are some people so sensitive to criticism of health technology assessment? What does it reveal about the decision-making culture, and why must it be confronted? Tomorrow will see a long-awaited change for one group of marginalised patients. What does it mean, why is it important, and what does it reveal and the challenge of advocacy and securing change?
Health technology assessment and why systems have it so wrong when it comes to patients and decision-making. The latest on the reform of the Opiate Dependence Treatment Program and why the compulsory acquisition of a hospital in Canberra highlights everything wrong with policy development.
A different approach this week with the discussion looking ahead to the end of June, with published outcomes expected on requests for relief from the stockholding commitment, detail on reform of the Opiate Dependence Treatment Program, and lots of discussions on health technology assessment.
Parents are showing remarkable courage in sharing their personal stories of loss in an attempt to convince the Albanese government to implement a pre-election commitment. A typo means the planned diabetes tender will proceed simultaneously with the recently announced parliamentary inquiry. How? Are 60-day dispensing and other changes going the same way as other recent reforms?
We focus on the Administrative Appeals Tribunal's negative reflections on the health department, the minister's criticism of 'clunky' HTA, and rugged exchanges at Budget Estimates between senators and officials on various issues, including 60-day dispensing and newborn screening.
Thoughts on the recent BPD annual conference and the latest on the dispute between the Albanese Government and pharmacy over the plan to increase dispensed quantities of over 300 medicines, including an interesting rumour. Readers' questions on a difficult discussion and next week's Senate Estimates hearing.
The 'Week in Review' was recorded at the BioPharmaDispatch annual conference and featured Cube's Anne-Marie Sparrow and Jody Fassina of Insight Strategy. We discuss the 2023-24 Budget, the ongoing fallout over the plan to increase dispensed quantities, and the range of other issues raised at Monday's event.
The 2023-24 Budget has revealed significant growth in the PBS in the current year. We unpack the numbers and discuss what might be driving potentially transformative growth. Health minister Mark Butler also announced reform of access arrangements for medicines for opiate dependence and nicotine e-cigarettes.
In a special pre-Budget episode of the 'Dispatched' week-in-review podcast, we discuss the Albanese government's move on pharmacy, how it reflects a broader policy malaise, good news for people living with opioid dependence but not so good on newborn screening, and why disability advocates should be worried if the PBS is going to be the new model for managing growth in the NDIS.
The Albanese Government is now in a fierce fight with the Pharmacy Guild over the plan to double dispensed prescription quantities for 325 PBS-listed medicines. Pharmacy will chip away at this issue over the next few months. What does that look like, and where does it go?
Culture and capability have been the focus this week. Will new leadership lead to change? Pre-Budget announcements are now coming 'thick and fast' but what else might we expect? We respond to questions from the audience about 'secrecy' and why the absence of celebrations about the 75th anniversary of the creation of the PBS?
The health department is about to get new leadership, which means change, hopefully leading to less of a 'smash and grab' approach to policy development. The upcoming 2023-24 Budget may not include specific new savings measures, but that does not mean they're not in there.
All questions from the audience today. Questions about what the government might want from the HTA review, 'conditionality' versus the 'managed access program', and why the tinkering on patient input to decision-making?
Any late-breaking news on the 1 April catch-up statutory price reductions? What is happening with the Albanese government's commitment to expanding Australia's patchwork of newborn screening programs? Questions from the audience about what next on pricing policy, whether it would be unfair, and what lessons can be learned.
Any surprises on the finalised terms of reference for the HTA review? The very clever politics of a 'supply only' arrangement and why the term 'commercial viability' confuses patients and masks the truth of changes that 'cut too deep'.
A change in the membership of the federal government's HTA review reference committee. What does it say about the review and what does it mean? Still waiting for final outcomes ahead of the 1 April price changes and a question from the audience about what patients can do to ensure their voices are heard.
Should we make this podcast 'confidential' by saying it's confidential? The Albanese government's unprecedented decision to release the rules for its first Budget. Could the industry be 'approached' ahead of this year's Budget given the challenging fiscal circumstances and the consistent focus on the need for savings?
Some companies are being paid a premium to keep their medicines on the PBS and well supplied while others are having their prices slashed to the point they are exiting the program. Is anyone else confused? And, why Ernest Hemingway provides the best metaphor for how people should approach the period ahead - the fisherman, the marlin and the shark.
We discuss the terrible treatment of the nurse-led Centre for Community-Driven Research and why everyone should be alarmed. We also ponder the almost $60 million the federal government has agreed to pay the TGA's landlord for its new laboratories.
A busy 'week in review' with a discussion about the 'confidentiality' arrangement for the HTA review, with someone who knows all about those things, and a focus on yesterday's Senate Estimates hearing that saw some very interesting revelations and a new dynamic between the committee and officials.
Are Australian patients getting Pharmac by stealth? How is it happening and how can it be stopped? Why everyone should be concerned about changes in one important area of health and the 'Occam’s razor' in the evolution of change.
What did the finance department tell the HTA review reference committee about its draft terms of reference? The TGA is looking for a new leader and there is a new home for genomics policy. We also respond to a question about the wider implications of an 'approach to market' for diabetes products.
Another week of consternation about the health technology assessment review and some questions from the audience, including one that challenges the exclusion of people from the consultation process but another that doubts there was any alternative.
The year starts with another controversy, this time over the draft terms of reference for the health technology assessment review. We discuss why nobody should be surprised and respond to questions from the audience about a potential solution and why confidentiality requirements are not a feature of other major reviews in health.
We take a month-to-month look at 2022 with so many events, outcomes and the fallout of processes. What does it all mean, what does it say about the year and what should we all expect in 2023?
What is a 'probity adviser' and why has one been appointed to the health technology assessment review? Events in New Zealand continue to evolve with one patient leader making a blunt diagnosis of what's ailing the Pharmac CEO. We also answer a question about 'ministerial discretion' and suggest the real process is only just beginning.
The year is ending with companies receiving disappointing news on their requests for relief from next April's 'catch-up' reduction day. What does it mean now and for 2023? The horizon scanning forum and the need for clarity from the health minister about what he wants from this and all the other ongoing processes. Audience questions focus on the 'renaissance' of Australian biomedical manufacturing.
This week's Pfizer 'Invites' event featured an interesting expert discussion on pandemic preparedness. We answer lots of listener questions on that issue and other topics, including why the medical device and frankly all stakeholders should push for close parliamentary scrutiny of three pieces of new legislation.
It is the anniversary of the report of the parliamentary inquiry into approval processes for new medicines and medical technologies and still no government response, but we do have the outcome of the review of the base-case discount rate. They both say so much about the current state of policy-making in Australia. We also answer audience questions on top-down patient consultation and whether everyone should be watching what's happening with the medical device sector.
We discuss the response to the reports of a problematic culture at the heart of HTA decision-making, the need for greater alignment across the pharmaceutical, medical device and diagnostic sectors, and answer your questions about statutory price reductions and patient 'consultation' processes.
We are joined by Better Access Australia chair Felicity McNeill to respond to questions submitted by listeners and give a shout-out to one patient advocate who in one social media post articulated a clear critique of PBS decision-making. We also discuss why more HTA is not a solution to delays in funded access.
We are joined by Better Access Australia chair Felicity McNeill to respond to questions submitted by listeners and give a shout-out to one patient advocate who in one social media post articulated a clear critique of PBS decision-making. We also discuss why more HTA is not a solution to delays in funded access.
We discuss Monday's Post-Budget Summit and a discussion that revealed an opportunity for a refreshed approach to political engagement. Medicines Australia has a new set of directors who will need to deal with a long-standing challenge and a raft of issues with its new agreement with the federal government. Next week is Senate Estimates and we would like to hear from you.
A busy week with the Albanese government delivering its first Budget. The reduction in the general PBS co-payment was a centrepiece. The Senate backed the enabling legislation with a very subtle but powerful amendment that proves the importance of detail in advocacy. The amendment and how it was achieved is an important lesson for stakeholders in how they approach the much-anticipated HTA review.
We review this Budget week, how it has changed over the years and what else might be revealed by Treasurer Jim Chalmers. Are some Senators pushing to amend the proposed PBS co-payment reduction? How is it a good idea to reduce patient participation in post-market reviews and why the discussion on health technology assessment is the policy equivalent of 'quick sand'?
We review this Budget week, how it has changed over the years and what else might be revealed by Treasurer Jim Chalmers. Are some Senators pushing to amend the proposed PBS co-payment reduction? How is it a good idea to reduce patient participation in post-market reviews and why the discussion on health technology assessment is the policy equivalent of 'quick sand'?
A new review of Australia's pandemic response confirms what we already knew about the failures in vaccine procurement and distribution, the new post-market review process removes patient consultation, it could be an interesting few weeks in the Senate for the PBS, the final days for companies to provide additional information in support of their case for relief from April's 'catch-up' price reductions, and one week until the BPD Post-Budget Summit.
A new review of Australia's pandemic response confirms what we already knew about the failures in vaccine procurement and distribution, the new post-market review process removes patient consultation, it could be an interesting few weeks in the Senate for the PBS, the final days for companies to provide additional information in support of their case for relief from April's 'catch-up' price reductions, and one week until the BPD Post-Budget Summit.
The 'Week in Review' includes a special guest who discusses the 'indicative outcomes' communicated to companies seeking relief from next April's 'catch-up' price cuts, the implications for public health, what they say about a system 'under strain' and why change is urgently needed. There is also a discussion about the recommended lung cancer screening program and how it provides further evidence of everything that is wrong with health technology assessment.
The review discusses 'what now' after the industry has presented its evidence on the disputed implementation of the PBS pricing framework, the challenge of timing, the potential implications of the multinational tax review, and planning for the BPD Post-Budget Summit.
The review discusses 'what now' after the industry has presented its evidence on the disputed implementation of the PBS pricing framework, the challenge of timing, the potential implications of the multinational tax review, and planning for the BPD Post-Budget Summit.
The first 'Week in Review' episode of 'The Dispatched Podcast' discusses the ongoing dispute over the implementation of the new PBS pricing framework, the 'Halton review' of Australia's COVID-19 vaccine and treatment procurement planning, and the significant implications of the new national anti-corruption commission.
The latest edition of 'The Dispatched' podcast pays tribute to the late Will Delaat AM and discusses the importance of detail, substance and long-term thinking when it comes to policy.
This episode focuses on the contentious 'catch-up' price reductions, the wording of industry agreements, the clever but consistent policy approach, the real risk of other 'surprises' and the discomfort of having to defend federal government officials.
Jody Fassina discusses the composition of the new parliament and its implications for politics and policy, the fiscal challenges confronting the new government and how stakeholders should engage the new ministry.
The latest edition of The 'Dispatched' Podcast discusses some of the frankly disturbing arguments against the implementation of a key Labor election commitment.
The Dispatched podcast discusses the mechanics of ministerial change. What happens? What are the challenges? The reality and how stakeholders should approach what is a significant change?
The latest episode of 'The Dispatched Podcast' discusses Labor's call for the Coalition to match its commitment to a national takeover of newborn screening and why the health technology assessment review cannot start until the National Medicines Policy review is restarted and finished.
In this week's episode, the 'Dispatched Podcast' discusses Labor's commitment to a national takeover of newborn screening. Why is there a need for change? What does the change mean for Australian families and how did we ever get into this situation?
What is in Budget 2022-23 and what is not. The lack of action on medicines affordability, funding for pre-symptomatic treatments but not screening for the disease and how the PBS forecast is money out but uncertain about money back in.
The political and policy condescension of patients needs to stop. The health technology assessment review has been called one of the biggest health reforms in the past 30 years. What is the competition and what will it need to achieve to sit alongside these major reforms? The federal government is about to deliver its pre-election 2022-23 Budget. What has changed and what to expect? What was it like as an official preparing a Budget?
The co-founder and chair of Better Access Australia, Felicity McNeill PSM, discusses the organisation's call for a delay in the National Medicines Policy review following the recent release of the revised document. She also says the upcoming 2022-23 Budget and federal election is an opportunity for political leaders to consider the rising challenge of medicines affordability.
BioPharmaDispatch is finishing 2021 with a podcast with Nicole Cooper of Convalis Consulting.Ms Cooper is approaching the fifth anniversary of her diagnosis with an advanced form of cancer. She talks ahead of her latest round of treatment and urges decision-makers to do better on understanding and supporting the experience and journey of individual patients.
The general manager and country president of Novartis Pharmaceuticals Australia and NZ, Richard Tew, says there are actions the government can take now to enhance the eco-system for biopharmaceutical innovation.Mr Tew says decision-making is characterised by collaboration and positive intent but it is just not designed for the new technologies already emerging from company pipelines.
The co-chairs of the Pharma Australia Inclusion Group, J&J's Fiona Sheppard and Pfizer's Lee Davelaar, discuss their personal journeys on diversity and inclusion, the group's activities in 2021, including how it supports companies, and plans for next year.
Jody Fassina of Insight Strategy shares his thoughts on today's Budget update and the upcoming federal election. He discusses the implications for stakeholders, including the pharmaceutical sector, the new politics of health and even makes an early prediction on the result.
Amgen's director of value, access and policy, Ian Noble, says Australia needs a clear vision to address the 820-day medicines 'access gap'.He says Amgen was disappointed with the report of the recent parliamentary inquiry and that a vision and agreed principles are essential to ensuring the pending health technology assessment review avoids becoming just another negotiation and actually delivers for Australian patients.
We discuss the claim Australia's most important document for medicines policy does not require a vision or overarching objective and why the National Medicines Policy review so far says everything people need to know about the problems afflicting PBS decision-making.
Dr Brendan Shaw of Shawview Consulting discusses the findings of his report commissioned by Johnson & Johnson on 'Getting Australia to the front of the queue' when it comes to access to new medicines and medical technologies.Dr Shaw says a key lesson of the COVID-19 pandemic has been the reality of a global queue for new technologies, including vaccines. He says the experience means Australians are now acutely aware of this reality and the fact we are not at the front of the queue.
The Senate backed the enabling legislation for the new PBS pricing framework but only after questioning from a key crossbencher that revealed more about the secret list of medicines used to calculate the $1.9 billion in savings. We also discuss the expected announcement of Greg Hunt's retirement and what about his successor will provide a very important signal on the government's plan for health.
The chief executive of Medicines Australia, Liz de Somer, discussed the report of the parliamentary inquiry into approval processes for new medicines and novel medical technologies, how the recommendations relate to the association's new agreement with the federal government and looks ahead to what will be a very busy 2022.
BeiGene's vice president of commercial for the Asia Pacific region Adam Roach discusses his background, career to date, disruption, as well as the company's plans for Australia and the region. He also shares his thoughts on some of the issues impacting medicines reimbursement, decision-making and patients.
BioPharmaDispatch discusses the report of the parliamentary inquiry into approval processes for new medicines and novel medical technologies with Better Access Australia co-founder and chair Felicity McNeill.We discuss the recommendations, the lack of any overarching objective and what the raft of proposed processes and reviews actually mean.
The co-founder and CEO of Rare Cancers Australia speaks with BioPharmaDispatch ahead of the organisation's CanForum event. He discusses its new report on the 'rights and responsibilities' of patients in Australia's health system and how to give real meaning to the notion of 'patient centricity'.
Nicole Cooper is the managing director of change management company Convalis Consulting. She is also a patient living with advanced colorectal cancer. She discusses her experiences of the health system, submission to the National Medicines Policy review and the urgent need for connection between decision-making and the lived experience of patients.