Harsh reality of shrinking PBS investment amid U.S. pressure to raise medicines pricing

A growing number of Australians are voicing concerns about access to innovative medicines, with new research from AbbVie Australia revealing strong public support for greater investment in the Pharmaceutical Benefits Scheme (PBS).

The Future of Medicines Access Poll, which surveyed 2,000 Australian adults, found that 90% believe the government should increase PBS funding. Furthermore, 75% of respondents said they would support a greater portion of their taxes being allocated to funding medicines.

Despite an increase in overall health expenditure, the share of PBS net spend has shrunk from 14% to 12% over the past decade. Compared to other OECD nations, Australia ranks 25 out of 33 for its medicines investment as a proportion of total health expenditure, lagging behind countries like Japan, Germany, Canada and Korea.

The Albanese government is under growing international pressure as U.S. lawmakers and pharmaceutical lobbyists ramp up efforts to force Australia to raise PBS medicine prices, cloaked as tariff negotiations.

In mid-July, 18 Republican senators penned a letter to U.S. Trade Representative Jamieson Greer and Commerce Secretary Howard Lutnick, urging the Trump Administration to use trade negotiations to dismantle “foreign price controls” on medicines by ensuring foreign countries “pay their fair share toward the cost of pharmaceutical research and development” and “appropriately value medicines developed and produced in the United States”.

The letter further called on the USTR to appoint a senior political official to “lead the charge on enforcing pharmaceutical pricing commitments globally.”

Against this backdrop, AbbVie ANZ General Manager Nathalie McNeil highlighted the need for Health Technology Assessment (HTA) reforms to improve access to medicines.

“AbbVie’s Future of Medicines Access Poll holds the mirror up, showing both the support we have for the PBS and critical need for the system to evolve. The PBS is a cornerstone of Australian public health, reflecting our commitment to access to medicines. However, without significant reform and more investment, we risk falling behind globally and failing Australians.”

She further added, “We know there are extensive and unacceptable delays from when a medicine is first registered in Australia and it being listed on the PBS. We also know that some medicines aren’t making it to Australia at all. We rank 16th out of 20 OECD countries in terms of access to reimbursed new medicines. As Australians we need to ask ourselves, is this good enough?”

The survey also shed light on the personal impact of limited PBS coverage. More than 43% of respondents reported having to pay full price for a prescription not covered under the scheme. Of those, 15% paid over $100 and some, over $5,000. Alarmingly, 10% said they had to borrow money, take on extra work, or even fundraise to cover their medicine costs.

Lisa Robins, CEO of Patients Australia, echoed the call for urgent reform.

“We’re calling for greater investment in the PBS and meaningful reform of the HTA process – to ensure all Australians can access the best medicines, when they need them, at a price they can afford. This is about health, hope, productivity, dignity, and time with loved ones. Medicines can keep people out of hospital, help them return to work, and give families more moments together.”

Although two-thirds of survey participants believe Australia’s health system compares well globally, 47% said they would contemplate leaving the country to gain access to a medicine not available locally.

McNeil issued a stark warning about the risks of inertia.

“As innovation and discovery in medicines development continues to propel forward, Australians are waiting. Government decision-makers must recognise the health, economic and societal benefits delivered by medicines and ensure our system does not delay or deny Australians access to the world’s most innovative medicines. Investment in the PBS is an investment in Australia’s future.”

Robins concluded with a powerful message, saying “We have a chance to get this right – for patients today and generations to come. Let’s not wait. Let’s act.”

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