Judi Moylan (Pearce, Liberal Party) Share this | Hansard source

It is a wonderful opportunity to speak to the National Health Amendment (Pharmaceutical Benefits Scheme) Bill 2007 because clearly medications have moved ahead in recent times; prescription medication saves the lives of thousands of people and indeed improves the quality of life of many Australians. The member for Newcastle was right when she said that this is complicated—it is—and there are tensions to be managed. But I think the government has struck a good balance between managing those tensions and trying to deal with the complications of such a bill.

As the scope of medications continues to widen and the price of some medications is well beyond what is paid by the consumer, the government or taxpayer meets the ever-increasing difference between what that medication actually costs and the cost to the patient. This bill seeks to change the pricing arrangements for medicines to ensure that the government receives better value for money for multiple-brand medicines without increasing the costs for patients and making sure that taxpayers get value for money in the dispensing of medicines.

These measures will ensure that the Pharmaceutical Benefits Scheme remains economically sustainable while ensuring that more Australians will have access to new and sometimes very expensive medications. Often the high cost of medications is not due to the price of manufacture but rather the arduous task of developing and testing drugs prior to manufacture and sale. This development process can take years before drugs go through a barrage of tests prior to government agencies declaring them safe for public consumption.

The Pharmaceutical Benefits Scheme provides a great service to the public by ensuring that access to a wide range of medicines is available. By effectively managing the scheme, the government will continue to support the listing of new and cost-effective medicines. Patients meet only the standard copayment of $4.90 for concessional patients and $30.70 for general patients. In some cases patients may pay less. The Pharmacy Guild has estimated that 400 brands will fall into this category.

The copayment is a responsible policy that encourages people to use medication as prescribed and to discourage the stockpiling of medications. There would not be a medicine cupboard in the country that does not have one or two bottles of unused prescription pills. At the same time the government has recognised the hardship that some people with chronic illness can experience due to the very high cost of daily pharmaceuticals and has provided a safety net for them—and quite rightly so. No-one ever knows when they are going to be in that situation. I think it is important, in a country like Australia, that we do make provision for people who have chronic illnesses and for whom medical and treatment costs are very high.

The Pharmaceutical Benefits Scheme will continue to provide a safety net, to make sure that medications are affordable for patients with high-use requirements. Medicines will continue to be dispensed to the public through community pharmacies, which I think is a very positive thing, but with a greater degree of transparency about the level of pharmacy remuneration, ultimately resulting in better use of government expenditure on medications.

The government announced in November 2006 that it would carry out a reform of the scheme to ensure good value for money, and this bill gives effect to that policy announcement. Since the announcement there have been a series of discussions with the relevant industries and industry representative organisations, including the Pharmacy Guild, Medicines Australia and the Australian Medical Association. These key stakeholders and others have indicated their general support for these reforms.

A structural adjustment package will be provided for pharmacy and pharmaceutical wholesalers through amendments to the community pharmacy agreement, including support for online claiming and incentives to dispense medicines that do not have additional patient charges.

The measures also include a method of streamlining the manner in which doctors can access ‘authority’ approvals for prescribing certain medicines. This has been raised with me by GPs in my electorate as I have done my rounds. They feel they spend far too much time on this process. This will reduce the red tape and allow doctors to get on with the business of looking after their patients—the business of doctoring.

The capacity for government to continue to fund new life-saving and life-enhancing medications well into the future relies on good management of the scheme and on managing those tensions that the member for Newcastle referred to. Having established the Parliamentary Diabetes Support Group in 2000, I have worked, along with my colleagues the member for Lyons, the member for Moore and other members, including Senator Barnett, to encourage the listing of appropriate and important new medications for those with type 1 and type 2 diabetes. Over that time we have seen a number of products come onto the market which improve both the quality of life for many people with diabetes and mortality rates.

Long-acting insulin, for example, helps people who are prone to hypos or blood glucose levels dropping dangerously low during the night when they are at rest and at risk of falling into a coma. These drugs have been particularly welcomed by parents of children with type 1 diabetes. You can imagine how concerning it is if they do not pick this up during the night by testing—and some families do that during the night—as the child may be in a coma by morning. So this was a very important listing. If we do not manage the Pharmaceutical Benefits Scheme properly and carefully, it could prevent some other medications from becoming available. As I said, I know that for many diabetics the listing of this medication on the PBS has been very welcome. We need to continue to carefully manage our resources.

Type 2 diabetes now affects 246 million people worldwide, and the numbers are growing very rapidly. For all those who are diagnosed, it is estimated that almost an equal number remain undiagnosed. Apart from the known drugs such as insulin—including, of course, the long-acting insulin—in recent times there have been a number of new medications listed. These products slow the progression of type 2 diabetes, and there are more products in development as we speak. We were advised of another one being looked at to come onto the market shortly.

Diabetes is a dangerous condition which, untreated, can lead to loss of eyesight, kidney disease and an increased risk of heart disease and stroke. It is the leading cause of limb amputation, meaning that every 30 seconds someone in the world loses a limb due to diabetes. In fact, few people realise that diabetes causes the death of 2.8 million adults, representing one death every 10 seconds globally.

In Australia, 7.4 per cent of the population has diabetes—they are the ones we know about—according to an AusDiab study in 2000. The social and medical costs were estimated in that same study to amount to about $6 billion annually. The human cost of diabetes is what most of us are deeply concerned about—that is, reduced quality of life and high mortality rates. By listing these types of medications on the PBS, there is a reasonable chance that the progression to dependence on daily insulin injections can be slowed, thus saving costs but, more importantly, improving the quality of life and longevity of those diagnosed with diabetes.

I am aware that there are many other chronic illnesses and conditions that in the past would render people unable to work and function, and in extreme cases result in early loss of life. It truly is a miracle of modern medicine that advances in pharmaceuticals can and do enhance quality of life and extend life for many people. That is where some of the tensions come in in managing cost, because what we do not want to do is stop innovation in the production of new medications that can not only reduce ongoing health costs but improve quality of life and reduce mortality rates. It is important to manage the tensions, but I think the government is mindful of that and has taken that into consideration in the development of this bill.

To continue to maintain access to all Australians, the government must ensure pricing structures that represent value for money for patients and for taxpayers. These measures will reduce the price government pays for medicines that are subject to competition between suppliers. It is important that patients also fully understand and are aware of the benefits of generic medicines. There will be a public education campaign to consumers, especially to those who are high users of PBS services, so that they fully understand what the changes are. It is particularly important to let consumers know that generic medicines have to meet the same very high standards of safety and effectiveness as any other medications. These are sensible measures to ensure the continuation of the excellent Pharmaceutical Benefits Scheme, a scheme that has wide public support. I commend those who have worked to bring about the changes which are the subject of the bill today.

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