PBAC and MSAC Chairs voice concerns, threatening more delays to HTA reforms

Sharp concerns from the Chairs of the Pharmaceutical Benefits Advisory Committee (PBAC) and Medical Services Advisory Committee (MSAC) have surfaced following the release of their initial reflections on the Health Technology Assessment (HTA) Review report, requested by Federal Health Minister Mark Butler.

In her letter to the Health Minister, PBAC Chair Robyn Ward did not mince words about the mounting challenges confronting the committee. While acknowledging advancements in the development and approval of medicines and health technologies, Ward highlighted that this rapid progress has brought “greater uncertainty about how effective, safe, and cost-effective new health technologies are – including how well they might perform in the community compared to existing care.”

Ward noted that the PBAC increasingly finds itself at the crossroads of “balancing reduced confidence in claimed benefits, higher costs, and demands for greater engagement and faster access to touted breakthroughs.” She warned that implementing the HTA Review’s recommendations would require substantial collaboration and pose significant challenges, particularly given their potential to cause “significant budget impacts” and necessitate extensive consultation with stakeholders.

Medicines Australia CEO Liz de Somer, however, struck a critical tone in response, saying “The previous PBAC Chair, Andrew Wilson, was a member of the HTA Reference Committee. The PBAC presented to the Reference Committee. Now we have a letter confirming the need for reform. It’s time to get on with implementation.”

De Somer pushed back against PBAC’s reservations about the safety and efficacy of new medicines, asserting, “We have a high-quality system of registration through the TGA, and Australians can have confidence in the medicines and treatments they have access to for their medical needs.”

MSAC Chair, Professor Jonathan Craig, echoed similar concerns. His letter to the Health Minister stressed that while patient and clinician expectations for rapid access to cutting-edge health technologies are rising, the accelerating pace of market entry compounds the risks of adopting interventions without fully understanding their comparative safety, efficacy, and cost-effectiveness.

Professor Craig cautioned against sacrificing robust assessment for speed, noting, “Timely access to health technologies is important, but achieving this should not be at the expense of robust assessment and equitable access.” He called for a careful balance, recommending reforms to support accelerated access while simultaneously disinvesting in underperforming health technologies.

The MSAC Chair was unequivocal about the scale of the task ahead. “Progressing reforms from this [HTA] Review will be a substantial undertaking and will take a significant amount of time and effort to design, consult on, and implement.” He emphasised the critical need for additional resources, warning that existing departmental capacity is already overstretched by current workloads.

De Somer further stressed the urgency of reform, saying “Incremental improvements as suggested by the PBAC will not ensure Australians can access the best medicines available as soon as possible after they are approved by the TGA. A delay of 466 days from the time of TGA-approval to when a medicine is reimbursed is too long.”

She dismissed framing HTA reform as a zero-sum game: “HTA Reform should also not be pitched as a trade-off. It is about creating the best system for Australian patients now and into the future.”

In a call to action, de Somer concluded, “Now is the time to get moving with reform implementation. We have the reform blueprint and the support of patient organisations, clinicians, government, and industry for system reform. There is no time to waste.”

With mounting pressure for reforms that deliver both safety and fast access, the path forward is fraught with challenges and delays. Yet, the stakes remain clear: Australian patients deserve a health system that balances innovation with accountability, ensuring timely and equitable access to life-saving treatments.

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