Monique Ryan (Kooyong, Independent) Share this | Hansard source

I rise today in support of the National Health Amendment (Cheaper Medicines) Bill 2025, a bill which will deliver tangible cost-of-living relief to millions of Australians by reducing the maximum Pharmaceutical Benefits Scheme co-payment from $31.60 to $25 from 1 January 2026. This is a welcome step. It will save families hundreds of dollars a year, and it will make essential medicines more accessible to those who need them most.

This government has done a lot to make medicines more affordable. In the last term of government, it brought in the 60-day prescription policy, which allows up to 12 months of medication at a time from a single script, with two months worth being dispensed at a time. This was a welcome change, which is expected to save more than $1.6 billion over four years for patients on stable doses of medication living with chronic conditions.

I have to say, though, that we've had relatively low uptake of the scheme to date. Only 21 per cent of eligible medicines were dispensed as 60-day scripts by the end of last year. Despite that, the policy has already saved consumers more than $110 million. If uptake increases to 50 per cent, annual savings could exceed $310 million for patients and $297 million for the government, primarily through reduced dispensing fees. I have to take some credit for this government's savings because I was the first person to raise this issue—the possibility of this policy change in the House—when I asked the minister if he would consider it, in early 2023. I was grateful to the government for considering the measure and adopting it. Like this bill, it was aimed at making things easier for Australians dealing with pretty significant cost-of-living pressures. But, while this bill is a positive move, it is not enough. It is a bandaid on a system which requires comprehensive reform.

As a paediatric neurologist who worked in a public health system for more than three decades, I know firsthand the importance of timely access to affordable and effective treatments. I also understand the frustration of patients and clinicians when access to life-changing therapies is delayed or denied because of outdated, opaque and slow approval processes. The waits are simply too long in our system. The average wait for approval under the Therapeutic Goods Administration is 12 months. For a clinical trial, it's at least a few months—long months when you've got patients desperate to get access to an exciting new possible therapeutic. For PBAC approvals, it's 22 months. For MSAC approvals, it's 12 to14 months. Horrifyingly, the average time for the approval of a new vaccine under the National Immunisation Program—from the time of TGA approval until listed on the NIP—is 1,375 days. That is 3.8 years.

I experienced those timelines firsthand when, after leading world-first clinical trials in children with severe neuromuscular conditions at the Royal Children's Hospital, I had to go, cap in hand, to the TGA and the PBAC and fight to have new medications and gene therapies approved and funded. It took years of advocacy, with families and with pharma, to secure access to those treatments for all Australian children. That is a false economy; we are talking about the health of Australians.

Just last week I met with a constituent who recently tried and failed to have an agent fast-tracked under our PBAC. The agent was actually TGA approved years ago; he was just trying to get it funded by the PBAC. He had spent a million dollars trying to get that approval. It failed because the government would not negotiate significantly on price. He's been offered the chance to reapply under the standard approval pathways, but he asked a very appropriate question: why would he bother? Why would he spend more of his money doing that, with a very limited chance of success? We are not rewarding those who are doing their best to bring new treatments to this country.

I've also heard recently from constituents whose children have been unable to access proton therapy. This is the best form of radiotherapy for brain tumours and many other forms of cancer. Despite attempts to bring it to our country, despite failed attempts by the South Australian and Victorian governments, proton therapy is still not available in Australia. That means that our children with brain tumours have to go overseas to access it, after their parents—these are parents who are under stress, dealing with the critical illness of their child—have had to jump through the endless hoops of the medical treatment overseas program to get them there.

I often hear as well from constituents who are frustrated that they cannot access the medicines they need. I've just spoken in this House about the many constituents who would like to access Novavax vaccines for COVID—can't do it. The PBS listings that were announced in this year's budget are a step forward for women's health. We've been hearing ad nauseum from the government about new listings for oral contraceptives, menopause and endometriosis. That's fantastic, but, if those women's HRT agents are unavailable, they find themselves having to settle for poor alternatives at a higher price. And they're not alone. Hundreds of medications are in short supply in this country at any one point in time. I've heard from palliative care physicians who can't get hold of the right forms of morphine for patients who are in pain and who are dying. I've heard from parents who can't get their kids' ADHD medications. I've heard of people who can't access their cardiac medications and the antibiotics that they want, need and deserve.

Both yesterday and today I've met in the House with vaccine providers, who have discussed their frustration with the barriers to approvals and funding in this country, particularly with respect to the mishmash of federal and state support for immunisation programs. I've often heard in Kooyong and in Canberra from constituents and carers frustrated by the variability of vaccine schedules from state to state and the variable funding of administration of vaccines by councils or by community pharmacists in different territories and states.

The health technology assessment system is the backbone of how we assess, approve and fund new medicines and medical technologies in Australia. The health technology assessment review was commissioned by the department of health in 2021 in response to a report from the joint standing committee on health, disability and ageing. That review was released in 2024. It exposed critical shortcomings in how Australia evaluates and funds new medicines and technologies. Those issues directly affect the speed and ease with which Australians can access novel life-saving therapies. The review called for a more transparent, more timely, more patient centred approach to the evaluation of new treatments. It recognised the need to better incorporate real-world evidence, consumer input and health equity into decision-making.

In response to that review, which was released, as you will remember, in late 2024, the Health Technology Assessment Review Implementation Advisory Group was established in November 2024, but there has been very limited progress since that time. Patients are still waiting. Their parents and the people who care for them are still waiting. Clinicians are still waiting. Researchers and industry are still waiting for action on the HTA review. We cannot afford to wait any longer.

The fact is that the PBS system which we all treasure has recently come under significant and renewed attack from large international pharmaceutical companies which have successfully mobilised the US government to apply pressure here and in other countries with schemes similar to the PBS. Those companies have variously criticised our PBS for allowing generic medicines to compete in the market, for freeloading by contributing insufficiently to the cost of research and development of new drugs and for taking years to approve new medicines and thereby creating a massive backlog of approvals. The Albanese government has rightly defended the PBS, and I think everyone in this place would do that. But the fact is that our therapeutic goods approval bodies would benefit by not being beyond reasonable criticism, because the criticism that they have received is reasonable. They are slow and they are overly administratively burdensome.

So this bill, while it is important, will not address the systemic delays that prevent Australians from accessing new therapies. It will not fix the bottlenecks in the TGA, the PBAC or the MSAC. It will not ensure that our health system is ready to evaluate and fund the next generation of personalised medicines, digital health tools and breakthrough therapies. Cheaper medicines are good, but faster access to the best medicines for all Australians is better. We need a system that recognises the complexity and wonder of modern medicine, one which is agile enough to respond to emerging health needs, one which puts patients, not bureaucracy, at its centre. So, I urge the Minister for Health and Ageing to prioritise the full and urgent implementation of the HTA review recommendations.

I do support this bill, but I also call on this parliament to look beyond it, to build a health system which is not just cheaper but smarter, fairer and faster. Australians deserve more than just cheaper medicines. They deserve the best medicines at the right time at a price that they can afford.

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