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Monday, 24 June 2002
Page: 2411


Senator CROWLEY (2:11 PM) —My question is to Senator Patterson, the Minister for Health and Ageing. Can the minister confirm that Celebrex is a significant factor in the cost blow-out in the PBS, confirming expert PBAC opinion at the time of listing that controls such as HIC authorisations should have been attached to the listing of this drug? Can the minister confirm that Pharmacia, the manufacturer of Celebrex, actually sought to have this medicine prescribed under authority when it was first listed? Wasn't this request rejected because the Health Insurance Commission advised that it could not handle the expected volume of phone calls from doctors requesting this authority?


Senator PATTERSON (Minister for Health and Ageing) —The Labor Party's questions indicate that they are concerned about the PBS but they are not prepared to do anything or to support the government, as we supported them when they increased the cost of the pharmaceutical benefits copayment. I think it went up 420 per cent under Labor for people on the general copayment.


Senator Chris Evans —You will only have to come in and retract it after question time, so get it right.


The PRESIDENT —Order! Senator Evans!


Senator PATTERSON —Now they are going to try and wind back the clock.


Senator Knowles —Are they going to take Celebrex off?


Senator PATTERSON —Good question, Senator Knowles. Will they take Celebrex off? With the suite of changes that we have brought in with the budget—not just, as I said, the increase in the copayment—we will be reviewing a number of medications. When a company applies to the PBAC to put a medication onto the PBS, they go through a process. The PBAC is a group of people who work incredibly hard for very little reward. I believe they do it because they want to make a commitment to Australia and to the PBS. They evaluate the information provided to them by the companies, using their skills as oncologists, doctors and people with a background in pharmacy. They use their skills to ensure that when medications go on they are cost effective, and they outline guidelines.

In the budget papers we have indicated that we will have improvements in the guidelines being put to doctors before medications go onto the PBS. I think that needed improvement. We will ensure that those guidelines are much more clearly outlined to doctors through a number of mechanisms. I think there was a problem in the sense that doctors were not always fully informed of the guidelines and the guidelines for prescribing those medications. In the budget papers we have outlined that a number of those medications will be reviewed to ensure that they are cost effective and to ensure that, as they have claimed, they have a better outcome than other medications which may be cheaper. For example, Celebrex argued that there would be less gastrointestinal problems as a result of it compared with other anti-inflammatory medications.


Senator Hill —They did what?


Senator PATTERSON —That was not terribly helpful, Senator Hill. Thank you very much. If you want to answer questions on health, I would encourage you to do so. What they will do is assess whether these medications are in fact better than the anti-inflammatory medications already on the PBS or whether their claims have not been sustained. We have that review process. As I have said a number of times, just increasing a copayment is not the only thing we have in the budget. There are a range of measures, including reviewing some of these medications. Let me just say to the Labor Party that they did not put in place some of the measures that we have put in place to ensure that medications are prescribed appropriately—with the Home Medicine Review Program and the National Prescribing Service. Under Labor, we saw antibiotics being prescribed at a rate that means that we now have in our hospitals bacteria that are resistant to antibiotics. We will wind back the clock and ask: where does the blame lie? It lies with the Labor Party in that they did not bring in appropriate prescribing regimes to ensure that we did not see the overuse of antibiotics.


Senator CROWLEY —Madam President, I ask a supplementary question. I note the minister argues that not enough has been done. I ask again: can she confirm that Pharmacia, the manufacturer of Celebrex, actually sought to have this medicine prescribed under authority when it was first listed—a very good thing to do to try to restrain pharmacists and doctors? What additional resources have been provided to the HIC so that expensive PBS medicines can be more readily prescribed on authority—a system to restrain the doctors' practices? What action has the minister taken to ensure that administrative excuses are not used to reject valid recommendations for controls, with the result that this government is just slugging the poorest and the sickest in the community?


Senator PATTERSON (Minister for Health and Ageing) —I will keep repeating that the poorest and sickest in our community will be slugged if we are unable to put new medications onto the Pharmaceutical Benefits Scheme because it is unsustainable. That is who will be slugged: the sickest and the poorest.


Senator Crowley —Did you deny the authorities?


Senator PATTERSON —Senator Crowley is asking about authority. Let me say to you that doctors find it a bit galling to have to ring up to get authority because it takes time. What we have done is to put in place an online authority system that facilitates that authority for doctors by speeding it up so that they are able to get the answer as quickly as possible—something that was not done under Labor. It ensures that they get the answer to the question about whether or not their medication can be prescribed for this particular patient as quickly as possible. The sickest and the poorest in our community will suffer in the next three, four or five years as a result of the fact that we will have to look at medications going onto the Pharmaceutical Benefits Scheme because it will not be sustainable into the future. (Time expired)