Dean Smith

In the Media


December 20, 2015

Sussan Ley: …It’s lovely to be here with representatives from Hepatitis Australia and Hepatitis ACT, with doctors and with patients, to make what I believe is a momentous announcement in the history of health and access to medicines in Australia.

We are listing four breakthrough drugs to cure Hep C. Now, there are six genotypes of Hep C as most of you know, and we waited to get this absolutely right, to list all four medicines together, but most importantly to make sure that without fear or favour, everyone affected has equal access. We’re one of the first, if not the first jurisdictions in the world to say every patient in every circumstance deserves to have the earliest possible access to these medicines.

So, Hep C is often called the forgotten epidemic, but we know that 230,000 Australians are living with it, 700 die every year, usually from advanced liver disease, and there are 10,000 new cases being contracted every year. So I want very much that Australia is able to cure Hep C in a generation. Today’s announcement actually allows that to happen.

I want to thank Senator Dean Smith and the Parliamentary Liaison Group for HIV Blood-Born Viruses and STIs for their hard work. They’re bringing together much of the advocacy around this issue. And I want to acknowledge that I don’t think there’s a person in Australia who won’t be delighted with this announcement today.

Hep C is not a disease that you contract in anyway because it’s your fault. It’s a disease that is seen in every walk of life in Australia. From high rise office blocks in our major capital cities, the captains of industry so to speak, to the homeless person on the street near where you live. And today’s announcement reflects our absolute determination to list medicines as early as possible. This is $1b billion over the next five years, and I am absolutely delighted to be making the announcements. Good news before Christmas, most importantly for patients. Thank you.

Question:      Minister, why not fund money into other drugs, for say, pancreatic cancer or something like that?

Sussan Ley:          Well this is a result of a list in process that comes through the PBAC. The process is long and when the drugs are breakthrough and the prices are high sometimes it takes a while to get it right. But we said when we came into Government that if our experts on the Pharmaceutical Benefits Advisory Committee recommended the listing of medicines, we would do it. So this isn’t about Governments choosing one medicine over another, it’s about us acknowledging that these medicines have been listed, they’re safe, they’re effective, they are indeed breakthrough drugs, then the challenge for Government is how do we pay for them. And the challenge for me I guess as Health Minister was to say I don’t want to do this in tranches. I don’t want to start with the most sick and move forward. I want everyone to have access. So that’s why it took a little bit of time since the listings earlier this year, to actually make this happen.

Question:      Will patients be able to get a hold of these drugs at a cheaper rate straight away?

Sussan Ley:          The listings will take effect on 1 March next year, so that’s very soon. People who are familiar with the process know that from the actual time of the announcement to the listing is a couple of months. And yes they will be able to get access and most importantly they will be able to get the treatment which is eight to twelve weeks, usually just tablet form, for $6.10 a script if you’re a concessional patient, or $37.70 if you’re a general patient, for treatments which may in some cases cost up to $100,000.

Question:      …is this being funded by, for example, the cuts to incentives for pathology and imaging services in MYEFO?

Sussan Ley:          This is part of our MYEFO announcement, but because the discussions with the drug companies were at a confidential stage, I wasn’t able to announce it last week. So yes, this is part of MYEFO, and obviously what we do is we have spends and we have saves. And we needs the saves, some are small, some are big, in order to make the spends. But this demonstrates that this Government is prepared to make the tough decisions to prioritise where we should put our health dollar in Australia to the best affect, and to be able to do a $1 billion listing in tough economic climate- a tough climate such as we have now, I think is testament to the strength of our processes and our commitment to patients.

Question:      In your private health insurance review you asked whether smokers should have to pay more for private health insurance, because they’d made a lifestyle choice to smoke. Most of the people who will benefit from this drug are drug addicts or prisoners who made a lifestyle choice and acquired a disease as a result. Should you be asking the same question about whether they should be contributing more to the cost of this treatment, as smokers should for private health insurance.

Sussan Ley:         Well, firstly, the question about smoking wasn’t in my review, it was in a questionnaire, an online survey, that went to Australians generally, and it’s important when we get the feedback to have everything on the table, to ask people what they think. So the suggestion that that’s finding its way into Government policy is not correct. We don’t make judgements. We don’t make judgements about people’s lifestyle choices and we’re certainly not doing that in this case. No questions will be asked. In order to eradicate Hep C within a generation, which is our intention, we do need to treat everyone, and that includes the prison population. And that was the subject of an early discussion I had with my department and those who would fund the medicines. because this is, I want to emphasise, a treatment that will be available for everyone, without fear or favour.

Question:      Just back on the earlier question about MYEFO and the cuts to pathology subsidies, presumably pathology plays an important role in the diagnosis of Hep C. The AMA is warning that cutting these subsidies will increase the costs to patients of pathology and some people will skip important tests here. So isn’t this creating a problem out of the solution.

Sussan Ley:         Well, no it’s not. And you’ve described the payments to pathologists as subsidies, which is quite a good term, because in fact they’re not the core payments that we make under the MBS. They’re not the remuneration for services. They’re an add-on, they’re an incentive, they’re an additional layer introduced by the previous Government in order to increase the rate of bulkbilling in pathology and diagnostic imaging. And my question was and is – that’s a bit rhetorical – why should the Government allocate $500 million in order to keep a service at the same level, maintain the status quo. We shouldn’t. It’s a good example of it’s not the best spend to our health dollar. So I don’t expect any reduction in the access to pathology, certainly not as a result of this announcement.

Question:      Can you explain how the health cuts work in MYEFO? Could patients be paying $3 for pathology services and up to $6 for an x-ray for example.

Sussan Ley:         What patients pay for pathology and diagnostic imaging is determined by the provider, not by the Government. And the money we provide to those diagnostic imaging and pathology services is a revenue stream for them. They make their own charging decisions as a result. And I’ve certainly noticed that, as I move around the country, in some regional cities, where there is competition, then the cost to patients is much lower right here, right now, than it is in other locations where there isn’t any competition. Pathology for example, its 5,000 providers. It’s very corporatized- 5,000 collection centres I should say, two main providers. And lots of competition, otherwise we wouldn’t have that number of collection centres around the country. It is the competition that quite correctly keeps the price affordable for consumers.

Question:      But it’s not quite the status quo if both those providers are saying that they will introduce a co-payment. Is that correct?

Sussan Ley:          Well, let’s wait and see what actually happens. I will be asking some tough questions of any provider who associates a temporary revenue stream that was added on top of their regular payments through the MBS only a few years ago, and then seeks now to pass it on to patients. That in my view is not appropriate.

Question:      Hepatitis C, sorry, can I just get back to that. Given that, as you’ve mentioned, in many cases this is a disease that can be prevented before someone contracts it, is it efficient use of money to be spending- subsidising pharmaceutical companies and their medicines, when you could be putting that money into preventative measures?

Sussan Ley:          Well, preventative health is vital, and we will continue to do that, and I look forward to all of the work that groups such as Hepatitis Australia do. And our Parliamentary Liaison Group is in close contact with everyone who works on an advocacy, preventative health- that is if you like a separate area of health policy. People don’t get Hep C because it’s their fault. They have this debilitating disease through no fault of their own. And the approach that we’re taking today is about saying we are here for you as patients and our intention is to cure this disease within a generation. And I know that this will be warmly welcomed by many across the country.

Now, we’ve got to go inside. So we might just wind up.

Question:      Just on another matter. Malcolm Turnbull has confirmed that he did send Duncan Lewis Andrew Hastie’s number in a text message. Is that appropriate of the Prime Minister to do?

Sussan Ley:        It’s entirely appropriate and on that subject I have no further remarks to make. Guys, is there anything else on Hep C? Because we’re actually here to talk about that.

Question:      One more question if that’s okay. Will people with chronic ailments such as osteoarthritis or concession card holders be worse off as a result of PBS changes that come into play on 1 January? So next weekend?

Sussan Ley:          Well, no they won’t. And again, I will be scrutinising the commercial decisions of the companies who manufacture over the counter medications who should not be choosing this moment to increase their prices. Panadol is available in your supermarket for about $2 a packet, and the Government has been paying $70 million to provide Panadol through the PBS. It’s a perfect example of an inappropriate and inefficient use of our health dollar. Thank you.

Question:  …about anti-vaxxers pulling down posters [indistinct] and replacing them with their own literature. Do we need to get tougher against these sorts of people and the misinformation campaigns they’re promoting.

Sussan Ley:          Well, we are tough when it comes to anti-vax because we’re saying no jab no play, if you choose not to vaccinate your child it’s outrageous that you should then present your child into an environment where other children with a more vulnerable, more compromised immune system, might catch whatever it is you should be vaccinated against. So we’re educating, we’re encouraging. We’re using I think is a fair balance of carrot versus stick. Thank you.

Question:      Minister, just on the different- if this is part of MYEFO and this spend starts on 1 March 2016, but those pathology cuts and that sort of thing within MYEFO, there are sort of signals that Labor and the cross bench might oppose this in the Senate or in Parliament. Is this sort of banking on a saving that hasn’t quite gotten through yet, before you spend it.

Sussan Ley:          Well, you’re talking about normal budget processes. I have every expectation that Labor will pass these saves because they make perfect sense. And particularly in the context of an announcement like today, when we are investing $1 billion over five years to cure Hep C, they make perfect sense. Thank you.