PBAC issues criticism of pharma industry’s reimbursement submissions

The Pharmaceutical Benefits Advisory Committee (PBAC) Chair, Professor Robyn Ward, and Deputy Chair, Jo Watson, have issued a rebuke to the pharmaceutical industry, accusing companies of failing to provide adequate information in reimbursement submissions.

In a correspondence following the March meeting, Professor Ward and Ms Watson, called out the “lack of full information and materials for the Committee to be able to acquit its responsibilities under the relevant legislative requirements.”

They stressed that to provide “the most appropriate and considered advice to Government,” industry sponsors must deliver “meaningful evidence, data and effective price estimates” that can be evaluated against clinical and economic claims.

The PBAC warned that incomplete or insufficient information forces companies to refile their applications. This, they noted, fuels a cycle of “submission churn,” stretching limited resources and driving “unfortunate delays for clinicians and patients in the community.”

In related news, the PBAC has acknowledged new pressure from Federal Health Minister Mark Butler, who has requested formal advice on equitable access to obesity medicines. The Committee said it has begun broad discussions and will consult with key stakeholders over the coming months.

Meanwhile, in its consideration of a submission for cervical cancer treatment, the PBAC took aim at Australia’s progress toward its bold goal of becoming the first country to eliminate cervical cancer by 2035. Australia may be an “early adopter” of the National Cervical Screening Program and HPV vaccination – but the PBAC issued a sobering reminder: inequities remain stark, especially for women in remote areas and young Aboriginal and Torres Strait Islander people.

Turning to cancer drug access more broadly, the PBAC noted Australia’s significant uptake of newer medicines, with some treatments transforming previously terminal conditions into chronic ones. Yet the Committee didn’t shy away from scrutinising the “modest clinical benefits” of some high-cost new cancer drugs in areas already well-served by effective therapies. It urged the industry to refocus attention on diseases with high unmet needs, where drug development has stagnated for years.

“The committee would like to note that it would welcome any future applications for drugs for these patient groups from relevant sponsors,” Professor Ward stated.

The PBAC also made a strong case for recognising medicines that improve patients’ quality of life, even in the absence of survival benefits. It welcomed recent submissions that prioritised symptom relief, backed by consumer and clinician commentary, affirming its commitment to “supporting meaningful quality of life improvements for patients when such submissions are available.”

However, the Committee highlighted a growing problem: clinical guidelines are evolving faster than PBS restrictions. Many new medicines have been introduced, yet outdated PBS restrictions remain, often clashing with current best practice.

In response, the PBAC reiterated its commitment to collaborate with clinicians, sponsor companies, and consumers to update these outdated restrictions.

“This work will allow the PBAC to better position new medicines for the benefit of patients and to support their clinicians in delivering optimal clinical care in Australian settings,” Professor Ward stated.

In reimagining healthcare across the entire patient journey, Health Industry Hub^TM is the only one-stop-hub uniting the diversity of the Pharma, MedTech, Diagnostics & Biotech sectors to inspire meaningful change.

The Health Industry Hub^TM content is copyright protected. Access is available under individual user licenses. Please click here to subscribe and visit T&Cs here.