Access denied: How the HTA system is failing cancer patients when time matters most

The Medical Oncology Group of Australia (MOGA) Oncology Drugs Working Group is continuing its advocacy alongside the Bridging Funding Coalition with a warning to government: Australia’s sickest patients can’t afford to wait.

Formed in late 2024, the Coalition brings together a powerful alliance of stakeholders including MOGA, the Leukaemia Foundation, Private Cancer Physicians of Australia (PCPA), Peter MacCallum Cancer Centre, Icon Group, Australasian Gastro-Intestinal Trials Group, AstraZeneca and GSK – united in pushing for reform to a long-standing flaw in the health technology assessment (HTA) system.

At the heart of the problem is an average 442-day delay between Therapeutic Goods Administration (TGA) approval and Pharmaceutical Benefits Scheme (PBS) reimbursement of critical medicines. For patients facing life-threatening diagnoses, this prolonged wait can be the difference between survival and lost hope.

Co-Chairs of the MOGA Oncology Drugs Working Group, Dr Deme Karikios and Associate Professor Christopher Steer, have been relentless in their push for reform. Yet, despite the united calls from the Bridging Funding Coalition, the Labor government walked away from the opportunity to make bridging funding a federal election commitment.

Dr Karikios highlighted the example of Tagrisso (osimertinib), a novel therapy for EGFR-mutated non-small cell lung cancer (NSCLC). Despite strong clinical evidence and international endorsement, the drug languished in funding limbo for more than a year before being listed on the PBS. The delay was especially frustrating given that Tagrisso was already approved and reimbursed in advanced disease.

“Clinicians get terribly frustrated when they know there’s a better solution for their patients and they can’t get it,” Dr Karikios said.

Another case in point is Imfinzi (durvalumab), an adjuvant immunotherapy for limited stage small cell lung cancer (LS-SCLC) that demonstrated robust results in a major trial. The therapy was TGA registered in February and is not yet reimbursed. Under a bridging funding model, access to such promising treatments would be accelerated, giving clinicians the tools they need without delay.

A/Professor Steer, President of PCPA, called for a bridging funding to end the cancer lottery and enable more Australians to access time-critical cancer treatments.

“The financial toxicity of the [cancer] diagnosis is a big problem. Add into that the fact that sometimes treatments that the science tells us should be used are not subsidised. The current HTA is failing,” said A/Professor Steer in a recent interview with Health Industry Hub.

Other countries, such as the UK, have implemented models like the Cancer Drugs Fund, demonstrating that timely access and fiscal responsibility are not mutually exclusive.

“This is not about new money. It’s about earlier implementation of drugs which get funded anyway,” A/Professor Steer emphasised.

Bridging funding aligns with the HTA Review recommendations. Yet, one year after the final report was submitted to the health minister, there is still no implementation plan, no agreed timelines, and little visible progress.

The consequences go far beyond disappointment. Patients are paying the price.

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