Health Minister to meet patient groups over exclusion from HTA reforms

As medicines policy enters a newly charged political phase, the very patients who spent four years contributing to the Health Technology Assessment (HTA) Review reforms face being structurally sidelined from the Strategic Agreement negotiations between Medicines Australia and the Labor government.

What was framed as a reform process grounded in evidence and patient voice is now being pushed into a confidential, politically sensitive bargaining arena. With no signal of funding in the May Federal Budget, the HTA Review implementation was rolled into the broader Strategic Agreement negotiations commencing 1 July.

In response to escalating concerns from patient organisations, Federal Health Minister Mark Butler has agreed to a tightly constrained 30-minute virtual meeting with patient group CEOs, facilitated by Patient Voice Initiative (PVI), scheduled for 9 July. The purpose is to examine whether any meaningful pathway exists to embed the patient voice into the Strategic Agreement negotiations relevant to implementing the HTA Review recommendations.

That meeting may also become the only near-term opening for more than 60 patient advocacy groups to finally access the long-awaited HTA Review implementation roadmap, which is still withheld from public view despite being submitted to Minister Butler in December by the Implementation Advisory Group (IAG).

Industry frustration is intensifying over a growing number of medicines recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) that are not reaching patients after price negotiations collapse. While the Pharmaceutical Benefits Scheme (PBS) subsidises around 950 medicines, an estimated 3,000 additional medicines approved by the regulator are not reimbursed.

Minister Butler has defended the Pharmaceutical Benefits Scheme (PBS) stating it is “fundamental” to Australia’s national identity, while insisting that “we only fund new medicines when the evidence shows they genuinely work and offer good value for taxpayers.”

Yet, Australians currently wait an average of 3.6 years for funded PBS access to medicines already available overseas, while only one in four new medicines available across OECD countries are funded domestically.

External pressure is also mounting. The US Administration’s Most Favoured Nation (MFN) pricing policy is adding strain to the Labor government’s efforts to preserve the status quo of the PBS. That tension has intensified further after the U.S. launched an investigation into Germany’s pharmaceutical pricing framework, citing what it described as “persistent underpayment” for medicines, as Germany moves to rein in healthcare costs, including pharmaceutical expenditure.

Meanwhile, broader consumer understanding of the PBS remains strikingly low. Only 17% of Australians say they know ‘a great deal’ about the PBS, while 58% report knowing ‘a little’, with the remainder having no understanding. That knowledge gap explains why some MPs report that medicines access is not a frequent issue raised by their constituents.

Against this backdrop, the absence of transparent and meaningful engagement with patient organisations, representing millions of voters, is emerging as a political risk for the current government.

The latest opinion polling has put One Nation ahead of any third force in Australian politics in the past 80 years. With less than two years until the next Federal election, the trajectory of that disruption is increasingly difficult to dismiss.

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