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Thursday, 4 April 2019
Page: 14940

Health Care

Dear Chair

I refer to your letter of 18 February 2019 concerning petition EN0831 to request the House of Representatives in-consider extending New South Wales (NSW) arrangements introduced in 2015 for the payment of medicine co-payments for those suffering from cancer and chronic illness to all Australians. I regret the delay in responding.

Under the Pharmaceutical Benefits Scheme (PBS), the Australian Government subsidises the cost of medicine for most conditions. In 2017-18, expenditure on the PBS was more than $10 billion. To help meet the cost of the scheme, patients pay a co-payment for their medicines and the Australian Government pays the rest of the cost.

States and territories are responsible for providing and funding public hospital services, including the supply of medicines to admitted patients. The Australian Government also provides significant funding to the states and territories to assist with the cost of providing hospital services. This includes access to subsidised PBS medicines for public hospitals through the Pharmaceutical Reform Agreements (PRAs).

In states and territories participating in the PRAs, which excludes NSW and the Australian Capital Territory (ACT), public hospitals access medicines subsidised by the Australian Government under two schemes:

PBS General Schedule (s85) medicines for non-admitted patients or patients upon discharge from hospital; and

PBS s100 Efficient Funding of Chemotherapy (EFC) for day-admitted or non-admitted patients.

The above two schemes are not available to ACT and NSW as these jurisdictions have chosen not to participate in the PRAs.

Under the PRAs, patients may be charged a co-payment up to an amount that would be equivalent to the charge that would apply at a community pharmacy for the supply of PBS medicines.

Separate to the PRAs, the Australian Government subsidises treatments for some cancers and chronic diseases such as cystic fibrosis and HIV through the PBS s100 Highly Specialised Drugs (HSD) program. The PBS s100 HSD program is available in all states and territories, including the NSW and ACT. A co-payment up to the equivalent of the PBS amount may be charged by the hospital for these medicines when supplied at a public hospital.

Since 1 October 2015. the NSW Government has paid for the patient co-payments for s100 medicines, including non-PBS subsidised s100 injectable and infusible chemotherapy medicines and PBS subsidised s100 HSDs, for NSW residents who are patients of NSW public hospitals or authorised NSW community prescribers. These co-payment arrangements are measures put in place by the NSW Government specifically for NSW residents and health facilities (excluding private hospitals). The NSW model of funding the patient co-payment for s100 medicines is a decision for each state and territory government to consider. I note that the ACT established a similar program in 2018.

The Government funds the majority of the cost of PBS medicines for Australians and at this time there is no intention to remove PBS co-payments. It should be noted that since 1 January 2016 the Australian Government has provided pharmacists the option to discount the PBS co-payment by up to $1 providing further savings to consumers.

Thank you for writing on this matter.

Yours sincerely

from the Minister for Health, Mr Hunt(Petition No. EN0831)