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Monday, 26 November 2012
Page: 13308


Mr LAMING (Bowman) (13:12): If we are going to make any progress in this place, we do not need a debate between two sides of the chamber where, on the government side of the debate, they are reading notes about standard therapy that is now old news. I would hope that they would realise that there is now triple therapy that involves protease inhibitors, which has more than doubled the treatment rates. What we heard from the previous speaker is just old-generation treatment propositions—for the simple reason that her very own government has not funded the triple therapy that is freely available and funded in a number of other economies.

This is a government that has completely traduced the role of the Pharmaceutical Benefits Advisory Committee. While it may invoke the advice of experts, it also has to follow that advice. This is a government that has finally unhitched and uncoupled expert advice from the PBAC from their own decisions in cabinet. We have here a government that is more worried about its own fiscal outlook and delivering a surplus in 30 June next than it is about the viral threats that people living with hep C face.

There is excellent triple therapy available. We now understand very well their implications, even in the most complex of patients—with, for example, serious sclerosis or post-liver transplant. Work has been done in France with early access to these drugs. That is years old. Around 6½ thousand people went to Barcelona—which the previous speaker referred to—and talked about the role of triple therapy, and there was a statement made about a commitment to making sure that it is available. There was a very, very good reason for that. There are 300,000 Australians who live with hep C, with 226,000 of them having more than just the antibody response—having a genuine clinical disease. Half of them may be lucky enough not to have symptoms. But let me make one fact very clear: every year that this government delays and dithers on world standard care that has been ticked off and approved by our expert committee represents hundreds of people in this country dying of liver cirrhosis—and a handful will die from hepatocellular carcinoma. So let us not have any more speeches from that side of the House, reading off talking points, talking about standard therapy that is 10 years old. The work has been done; it has been extensively evaluated. We know now there is even more in the pipeline coming through—new drugs that have even fewer side effects, lower levels of anaemia, less need to treat with thrombocytopenic treatments like eltrombopag, which is the treatment to basically push up production of platelets and reduce the need to lower levels of protease inhibitors, which then obviously reduces your risk of successful treatment and getting control of your viral load. But, no, we have a government that is going in circles.

I put a call out to the next two speakers: acknowledge that there actually is new treatment available in your speeches. It has been through your very own PBAC. Acknowledge that and give us the dates and not talk about where the excuses lie for not moving ahead and helping these Australians have the world-class care that can be accessed if you are a citizen of another country but not here.

What we are seeing in this uncoupling is a breaking up of the PBAC as we know it, from authorised treatments that get ticked off to a new world where they get ticked off by the PBAC but do not get funded by this government. I can appreciate that there have been times when vaccines worth hundreds of millions of dollars were subject to a ATAGI delays, but this is the PBAC and this is not a large amount of money for the uncertainty, the risk of chronic disease and ultimately of death that are faced by people with hep-C. I acknowledge the previous speaker for pointing out that almost a fifth of them have not been involved in injecting drug use, despite the stigma that is attached to that activity; and many of these people only did that once. Let us stop treating them like they are second-class citizens. Let us acknowledge that the treatments are now available and extensively evaluated. It is called triple-therapy, and they have done an enormous amount of work on that around the world. So patients in Australia—there are 226,000 of them—would simply say to this government: 'What do we have to do? Do we have to have another World Hep-C Day on 28 July next year, where this treatment is not available?'

We have massive privacy issues already, reaching out to these patients. They are hard enough to find, in many cases, because five years ago they were told the treatment is too toxic and unpleasant—'So, don't worry about it; you don't need to be treated, you'll probably be okay.' But every month and every year matters. I say to the next two speakers—because I know their hearts are in the right place here—go back and talk to your very own Treasurer. I have said it once and I will say it again: the fiscal problems are self-induced. The fiscal pain that this government is facing next year, where it is effectively snookered on its promise to have a budget surplus, should never trump the people sitting behind me and the people around Australia who just look to Australia, with our world-class PBAC, to make the drugs available through a simple tick of this government's cabinet and at this time, it has not occurred.