Budget threat on drugs

Federal government plans to amend budget blowouts in the Pharmaceutical Benefits Scheme (PBS) could have dire implications for the chronically ill, healthcare advocates warned this week.

With the federal budget due in less than three weeks, the government has begun leaking proposals in an effort to gauge public reaction. Proposals flagged by the government include increasing the cost of medications covered by the PBS by up to 30 percent, as well as cutting some medications from the list completely.

Healthcare organisations have been quick to criticise the plans as over-simplified.

Those two options are the least effective solutions available and will impart worst impact on patients, health policy activist Martyn Goddard told Sydney Star Observer.

Goddard is a former member of the Pharmaceutical Benefits Advisory Committee (PBAC), the board of experts that recommend which drugs should be listed on the PBS. He was one of 10 committee members who resigned at the beginning of last year due to perceived interference by health minister Michael Wooldridge in the PBAC.

People with HIV would be hard hit by any price hikes in subsidised drugs.

People living with HIV/AIDS are often filling between three and four HIV-specific scripts per month and then on top of that are requiring other medications to deal with side effects and complications. So there is potentially a huge problem, People Living With HIV/AIDS (PLWHA) NSW president John Robinson told the Star.

Goddard, himself a long-time HIV-positive activist, agreed that medications to deal with the side effects of HIV treatment would increase under the government’s plans, but he rejected the notion that HIV-specific drugs will be affected.

I think the anti-retrovirals will be the last thing that would be taken off the PBS. The cost of HIV/AIDS drugs to the PBS at the moment is actually decreasing for the first time in history, the committee regards those drugs as being one of the scheme’s real success stories and they know how many lives are being saved, Goddard said.

[The government] would be crazy to try and cut there because they’d be costing more money somewhere else in the healthcare system, either through the loss of a person’s productivity or hospital admissions.

The PBS has long been plagued by spiralling costs, with last year’s $800 million budget blowout the worst yet, bringing the cost of the PBS to around $4 billion in 2001.

The AIDS Council of NSW president Adrian Lovney labelled the government proposals a cop-out.

It’s an easy answer that is intended to prevent a black hole in the budget, Lovney told the Star. This is a complex problem that needs complex solutions -¦ It’s about ripping money out of the budget to fund other things like defence expenditure and the cost of the government’s Pacific solution -“ it’s not actually getting the heart of the problem.

Goddard points to other possible solutions. One costly problem is leakage, whereby expensive medications de-signed for crippling illnesses are prescribed to patients with less serious conditions.

The PBS is not sufficiently flexible to recognise the way drugs are used in the real world. What we need is instead of having one price fits all for prescriptions, we should have different prices reflecting the different cost effectiveness of the way drugs are being used, Goddard said. We would then save a huge amount of money and we’d be able to say to treasury that we have genuine cost effectiveness occurring.