It has been estimated that by the end of 2015, around 45 780 people will have died from a form of cancer, listing Australia as the highest age standardised incidence of cancer in the world. This means that there are on average, 125 cancer related deaths every day. In regards to the treatment of diagnosed patients, various government authority bodies have been established to regulate medicines available to the public. Currently, cancer patients in Australia are unable to have access to drugs and are being denied medical advances that have been approved in other developed nations. Why?
Unfortunately for the majority of diagnosed cancer patients in Australia, access to drugs and applying for required treatments isn’t as open-door as one would hope. The Pharmaceutical Benefits Scheme (PBS) provides subsidies for patients and currently provides 80% of all prescription medicine dispensed in Australia. This being so, there is an alarmingly low rate of approval for cancer drugs. Some patients have been recorded to waiting up to six years longer for approval and as a result, patients are dying earlier because of this delayed access to treatment. At the current time, there are roughly thirty drugs that are waiting on the PBS, where the government subsidises the payment so that the public will be able to afford the drugs. The severity of the situation? People cannot access the funds that will assist them paying for the drugs, so in all respect they miss out. The evidence? Of 13% of total healthcare expenditure, the PBS accounts for only 6% of these costs. We are being denied. To put it in perspective for you, a new form of immune therapy for lung cancer patients called the PD-1 inhibitor has been approved for use in Japan and the USA. Calculated at $12500 per month, through PBS subsidies the payment could be reducing to only a couple hundred dollars. That is, if the drug is approved.
The establishment of a statutory independent expert committee, the Pharmaceutical Benefits Advisory Committee (PBAC), typically recommends new medicines for listing on the PBS. However 80% of first applications for new medicines are rejected by the PBAC. Access to cancer treating drugs is restricted under approval criteria which outlines that the PBAC must take into account the medical conditions requiring treatment, clinical effectiveness, safety and cost-effectiveness and comparison to other treatments available. The interplay of these key factors means that access is inequitable and many have speculated that government intervention in the listing processes and challenges regarding reimbursement by the PBS indicate a policy shift towards “fiscal control rather than patient access”. Just recently, Prime Minister Tony Abbott has cut the PBS budget by about 1.2 million dollars and as a result, is slowing down the number of drugs that are being approved to be a part of the PBS.
For cancerous patients that need access to drugs that are rejected by the PBAC, a separate government body has been enacted. All drugs available for distribution on the market must receive regulatory approval by the Therapeutic Goods administration (TGA) before it becomes available. It is responsible for ‘regulating the supply, import, export, manufacturing and advertising of therapeutic goods’. However, in relation to cancer, the TGA does not allow cancer drugs to be fast tracked for distribution and holds ultimate discretion into allowing drugs on the Australian market. As a result of this, our nation has fallen almost two years behind the US and nations of the European Union. But at what cost?
A Melbourne woman is paying $5000 every three weeks for a lifesaving drug because the PBS does not list the drug required for her illness, stage four cervical cancer. A close friend has been paying for her treatment, but Ms Prior said “the Federal Government should be footing the bill”, which has already hit $10 000.
In response to what seems to be an endless issue, an independent media group Cancer Drugs Alliance (CDA), made a submission to the Senate inquiry into the ‘availability of new, innovative and specialist cancer drugs in Australia’ just last week. Added to this, they are also examining the operation of the PBS, arguing that it has become outdated and redundant, in relation to such drugs and primarily the impact of delays in the approval process.
Local Canberra woman, Louise Manoe is well aware of the inadequacies and faults within the system, her partner being diagnosed with advanced lung cancer just last year. After undergoing radiation therapy and applications for clinical trials, Louise was only the forty-eighth person to apply in the nation-wide inquiry to the senate into fast tracking access to cancer drugs.
“I am concerned that the media isn’t even picking it up, we rely on the media to be the eyes of the world and see what’s going on and report it. They are meant to be informative…these things are happening in Canberra and people are unaware,” says Louise. “The only time it will be done will be before an election, and by that time it will be too late to do anything…people are dying.”
There are more than nine hundred cancer medicines available globally, and our nation is falling behind. We live in a world full of ignorance for a world of people not acting on their own behalf. We need to activate and legislate for people to survive cancer, because if we don’t we may as well just walk the plank.