Pharmaceutical policy issues played a major role in Australia’s recent national election. Shawview Consulting’s Brendan Shaw outlines the medicines issues that came under scrutiny during the campaign.
It was the first national election since the start of the COVID-19 pandemic, and it resulted in an historic change of government. The previous ruling conservative Liberal-National Coalition led by former Prime Minister Scott Morrison was swept from power with a sizeable drop in voter support of more than 5%. While also suffering a slight fall in its primary vote, the opposition Australian Labor Party, led by Anthony Albanese, has become the first centre-left Australian national government in almost a decade. But apart from the usual characteristics seen at Australian elections, what was particularly striking this time was the important role medicines played in the election campaign. Australians usually take their health policy seriously – remember, this is the country that deported Novak Djokovic for not being vaccinated against COVID – but several medicines issues were under the spotlight during the election campaign.
First national election since the pandemic started
Even before the 2022 Australian national election campaign commenced, one issue was the Coalition Government’s handling of the COVID vaccine rollout, or ‘strollout’ as it was colloquially called by critics. While ultimately Australia achieved one of the highest vaccination rates in the world, the Coalition Government faced a lot of voter and expert criticism over its handling of the rollout.
The vaccine rollout was criticised for being too slow – something former Prime Minister Scott Morrison himself conceded during the election campaign. There were also questions whether the Prime Minister had been honest with the Australian people when he said Australia was at the ‘front of the queue’ in getting COVID vaccines.
Another factor in the background was that at the end of 2021, the then Health Minister, Greg Hunt, one of the longest serving health ministers in Australia, announced he would be retiring at the 2022 election, meaning that whatever the election outcome there would be a new health minister.
Industry- government agreements
The former Coalition Government last year signed new five-year strategic agreements with both the innovative and generic pharmaceutical industries through their respective associations, Medicines Australia and the Generic and Biosimilar Medicines Association. Both agreements contain quite extensive policy commitments from government and the Labor Opposition committed to respect these agreements if it won government. This is significant as it is the first time such agreements have secured bipartisan support from both the Government and the Opposition prior to an election campaign.
Health Technology Assessment Review
A key commitment the former Coalition Government agreed with Medicines Australia was to conduct a major review of how health technology assessment is undertaken in Australia. Expected to start in July 2022, Medicines Australia has described this HTA Review as the first independent review of Australia’s system for listing medicines on the Pharmaceutical Benefits Scheme (PBS) in 30 years.
However, even as the then Prime Minister, Scott Morrison, was announcing the election date of 21 May, the HTA Review was mired in controversy. For reasons that still have not been fully explained, the Australian Department of Health announced who it intended to appoint as members of the HTA Review just as Parliament was being dissolved, including an ex-head of the Finance Department who has a track record of recommending substantial cuts to the PBS. During the election campaign, the Labor Opposition reserved its right to revisit these appointments should it achieve government, so this issue remains to be resolved.
House of Representatives inquiry into access to new medicines and technologies
A major parliamentary inquiry into the way Australia evaluates and provides new medicines and medical technologies to its people was released at the end of 2021. It made many significant recommendations on ways to improve the system. This review by a committee of the House of Representatives could be an important input into the government’s forthcoming HTA Review, but it is currently sitting on the shelf waiting for the new Labor Government to respond to the inquiry’s recommendations post-election. These recommendations include better managing HTA for rare diseases, cell and gene therapies, combination therapies, orphan drugs, greater patient involvement in evaluations, managed access programs, international collaboration, diagnostics and genomic testing and clinical trials. The former Coalition Government did not respond to this inquiry, so the new Labor Government the new post-election Parliament will have the opportunity to do so.
National Medicines Policy Review
Then there is the long-awaited National Medicines Policy (NMP) Review. The NMP is an over-arching set of policy principles and objectives for Australia’s medicines policy environment. It was released in 2000 but has not been reviewed or updated since. Stakeholders across the health system have been calling for it to be updated. After several false starts, the former Coalition Government undertook a Review, although it was widely panned for not being strategic or aspirational enough. The former Coalition Government agreed to extend the time for the NMP Review to allow further consultation and provide industry, patients and the Australian community a greater opportunity to contribute to the process, but again the election overtook events.
Reductions in general patient PBS co-payments
In an environment where cost-of-living pressures were a major political issue in the campaign, both the Morrison Coalition Government and the Albanese Labor Opposition announced plans to cut the general PBS co-payment paid by patients for their medicines. The Coalition announced it would reduce the A$42.50 general co-payment by A$10 to A$32.50 if it was re-elected to government, while Labor announced it would reduce the same co-payment by A$12.50 to A$30.00 if elected. Details of how these co-payment reductions will be implemented and their impact on PBS safety net patient protections and the supply chain have yet to be confirmed.
Manufacturing medicines and vaccines
In the lead-up to the election there were various commitments to promote science and medicines in Australia, including the Morrison Government’s partnership with Moderna on establishing a new mRNA vaccines plant in Melbourne and the creation of a new agency, Genomics Australia, to support the adoption of genomic testing and health services. There were also announcements from Labor during the campaign to bolster Australia’s life science innovation capabilities, such as commitments to create a A$1.5 billion medical manufacturing fund and expand the scope of screening and testing for new-born babies.
Arguments over new medicines during the election campaign
During the campaign several major new listings of medicines on the PBS were announced by the Coalition Government. Morrison also singled out the PBS during the campaign and claimed success in funding new medicines for public subsidy, while trying to contrast with what he said was Labor’s failure to fund medicines recommended for funding when Labor was last in government. This highlighted that access to medicines and vaccines has become a key political issue in Australia.
The post-election environment and pharmaceutical policy issues going forward
While the post-election environment presents significant opportunities for Australia and the life sciences industry, it will mean a lot of work on major medicines policy issues. How deftly industry, patient groups, health groups and the new Government manage these issues going forward may be the difference between Australians being first in the queue in accessing medicines and vaccines in the future or not.