The breakthrough cancer, mental health and arthritis medicines that will never be subsidised
Cancer, mental health and arthritis drugs approved for the PBS will never be listed despite a government promise to add every medicine that has been endorsed to the nation’s subsidy scheme. This is why. SEE THE LIST OF MEDICINES
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Exclusive: News Corp can today reveal the secret list of medicines approved for government subsidy but have never made it on to the Pharmaceutical Benefits Scheme.
Tens of thousands of patients with cancer, arthritis and other diseases are missing out on breakthrough new medicines approved for government subsidy despites assurances from Health Minister Greg Hunt that he would approve their listing.
Hunt has repeatedly promised “if the medical experts, the Pharmaceutical Benefits Advisory recommends the listing of a medicine - we will list that medicine”.
With that in mind - News Corp - in today’s special investigation - has listed the medicines approved by the Pharmaceutical Benefits Advisory Council that are not subsided.
This includes a $48,000 prostate cancer drug that could help thousands of men and extend their life by more than 30 per cent.
It’s just one of a dozen medicines approved for reimbursement that have never made it on to the nation’s medicine subsidy scheme.
Our investigation has found many medicines are never subsidised because the pharmaceutical companies that make the drugs have failed to reach an agreement with the Department of Health on how much they will be paid for the medicine.
As a result they have decided not to supply the medicine under our subsidy scheme.
Drugs denied a subsidy include the breakthrough prostate cancer drug Xofigo which could benefit 3500 Australian men with castration resistant cancer.
Xofigo was first recommended for public subsidy by the Medical Services Advisory Committee in April 2014 and again by the PBAC in November 2017.
The Prostate Cancer Foundation of Australia and the Australian Advanced Prostate Cancer Support Group campaigned for the subsidy.
Last year, Jim Marshall, convener of the Australian Advanced Prostate Cancer, calculated more than 13,800 men had died from prostate cancer while waiting for the subsidy.
Pharmaceutical company Bayer announced in June it was withdrawing its bid for a subsidy and it told News Corp it “has decided not to proceed at this time”.
Today, we can reveal a medicine for crippling rheumatoid arthritis - Kevzara - has also been withdrawn after the company that makes it failed to reach a deal with the Federal Department of Health.
A prefilled syringe version of Abilify Maintena, a drug for schizophrenia, has been approved for PBS subsidy but the company has advised it is not proceeding with the listing.
Other medicines never listed would have given patients and prescribers greater choice – such as a competitor to EpiPen for anaphylaxis and a lower dose of cancer medicine Keytruda.
The PBS subsidises the high cost of breakthrough prescription medicines reducing the price to just $6.50 for pensioners and $40.30 for general patients.
Before the subsidy can be paid, the Pharmaceutical Benefits Advisory Committee must rule the medicine is cost effective and recommend a subsidy.
The pharmaceutical company must then enter negotiations with the Department of Health to agree on what price the government will pay for the medicines when it is listed on the drug subsidy scheme.
A spokesman for Health Minister Hunt said, by law for a medicine to be listed the expert PBAC had to recommend it and the sponsor had to accept its conditions.
“There are no cases under this Government where the PBAC has made a recommendation and the company has accepted the legally required conditions and the Government has declined to list,” he said.
The Government cannot compel a sponsor to list their medicine on the PBS, the spokesman said.
Consumers Health Forum Australia spokesman Mark Metherell urged the government to list medicines recommended by experts as soon as possible.
Opposition health spokesman Chris Bowen said: “The Minister falsely claims that the Government lists every drug when the reality is patients are missing out. This is not acceptable.”