‘Trust ebbing away’: HTA reforms suffocate under bureaucracy while patients wait

It’s been over two years since the Health Technology Assessment (HTA) Review commenced and more than six months since the final report was released, yet the government has barely moved the needle. In a candid interview, Nathalie McNeil, VP and General Manager at AbbVie ANZ, and Ann Single, CEO of Patient Voice Initiative and VP of HTAi, laid bare the frustration setting in among stakeholders.

Progress has been minimal, transparency is murky at best, and hopes for sweeping reforms are slowly suffocating under layers of bureaucratic delay. The consequences go far beyond disappointment. Patients are paying the price.

“We have to keep implementation of reform as an urgent priority because we’re operating within an HTA system that is not keeping pace with technology nor community expectations,” McNeil emphasised.

“We have more than 50 patient organisations acting as a collective and willing to support implementation, but we need some signs of movement,” Single urged.

At the recent National Press Club debate and the earlier post-budget briefings, Health Minister Mark Butler and his opposition counterpart, Senator Anne Ruston, carefully sidestepped any meaningful discussion on the HTA reforms. Neither offered detail, timelines, or transparency – just vague assurances.

“What concerns me as time drags on is trust ebbing away. It’s taken decades to get that trust [from patient communities] and I don’t think any Australian can afford for us to lose it now,” stated Single.

Stakeholders have pointed to the conservative stance taken by the PBAC and MSAC Chairs, who responded to the HTA Review report with what many have described as lukewarm at best, dismissive at worst. The duo dig deeper into the roadblocks behind this sentiment.

“We have to accept that there will be some instances of experiencing discomfort from all stakeholders. I acknowledge that there is tension in the system when we look at the work ahead of us all to reform our HTA system. All organisations must play a role in realising the change we need,” stated McNeil.

Single looked abroad, pointing to the UK’s recent NICE HTA review as a source of practical lessons. She said, “We know that HTA has been a valuable tool for quality, universal health coverage in Australia and overseas. But here in Australia it needs to be faster, more transparent and smarter about ensuring that clinical and economic knowledge is complemented with patient knowledge.”

When asked what each leader expects from the next government, the answer was unequivocal: a firm commitment to implement the HTA recommendations with urgency and accountability. They warned that anything less would represent a betrayal of the time, trust, and voices invested in the HTA Review.

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