Australians living with multiple sclerosis will continue receiving cheaper access to life-changing medical treatments, after an expert advisory panel decided to maintain taxpayer subsidies for key drugs. The health minister, Mark Butler, confirmed on Thursday that the drugs – Ocrevus, Kesimpta and Lemtrada – would not be removed from the Pharmaceutical Benefits Scheme (PBS), ending uncertainty as manufacturers pushed the government not to reduce the price they paid for drugs.
Butler said he supported the drugs remaining on the PBS because of their clinical benefits. However, the advisory committee has also called for a rapid review of the use of MS drugs, set to be completed before the end of the year, when a final decision will be made.
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Why Are Some PBS Treatments Under Threat?
It comes after a number of pharmaceutical companies have pulled drugs – or said they could be withdrawn – from the PBS in recent months. The moves have led to key questions about the government scheme: why are some PBS treatments under threat, and how much is US policy influencing this?
One major factor is the Inflation Reduction Act in the United States, which allows Medicare to negotiate prices for certain high-cost drugs. This has created global ripple effects, as pharmaceutical companies seek to protect their profits by withdrawing from smaller markets like Australia.
How Does the PBS Work?
In Australia, to keep prices down, about 90% of medicines are subsidised through the PBS. This enables affordable access to medicines that would otherwise cost thousands of dollars. An independent expert body, the Pharmaceutical Benefits Advisory Committee (PBAC), first evaluates the health benefits and cost-effectiveness of a drug and recommends whether it should be subsidised.
The government then negotiates and sets the wholesale price of each PBS medicine with the relevant drug company – but does not actually buy them. Instead, it subsidises the retail price at the chemist, at $7.70 for pensioners and $25.00 for others. The cost of the PBS to the government is the difference between the wholesale and the retail price.
Comparison: MS Drugs on the PBS
| Drug Name | Condition | PBS Status | Annual Cost Without PBS |
|---|---|---|---|
| Ocrevus | Multiple Sclerosis | Maintained | $30,000+ |
| Kesimpta | Multiple Sclerosis | Maintained | $25,000+ |
| Lemtrada | Multiple Sclerosis | Maintained | $50,000+ |
Key Takeaways for Australians
- MS drugs Ocrevus, Kesimpta, and Lemtrada remain on the PBS for now, ensuring affordable access.
- A rapid review of MS drug usage is due by end of year, which could change future listings.
- US policy under the Inflation Reduction Act is influencing global drug pricing and availability.
- Patients should stay informed and consult their doctor about any changes to their medication coverage.
FAQ
What is the PBS and how does it help with MS drugs?
The Pharmaceutical Benefits Scheme (PBS) is an Australian government program that subsidizes the cost of prescription medicines, making them affordable for patients. For MS drugs, this means treatments that could cost tens of thousands of dollars annually are available for as little as $7.70 for pensioners.
Why are some PBS drugs under threat?
Pharmaceutical companies are withdrawing or threatening to withdraw drugs from the PBS due to pricing pressures. This is partly influenced by US policies like the Inflation Reduction Act, which allows Medicare to negotiate drug prices, leading companies to seek higher profits elsewhere.
How is Donald Trump involved in Australian drug pricing?
While not directly involved, the US Inflation Reduction Act, passed during the Biden administration, has created global pricing shifts. However, Trump-era policies on drug pricing and trade have also influenced pharmaceutical companies' strategies, affecting markets like Australia.
For now, Australians with MS can breathe a sigh of relief as key drugs remain on the PBS. But with a rapid review looming and global pressures mounting, it's crucial to stay updated. Consult your healthcare provider about your treatment options and consider advocating for continued PBS support.