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Transcript of interview with Leon Byner: 5AA Adelaide: 2 September 2019: cost of antibiotics

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Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

The Hon. Greg Hunt MP Minister for Health

Minister Assisting the Prime Minister for the Public Service and Cabinet


2 September 2019



Topics: Cost of antibiotics

LEON BYNER: Now coming up, I'm going to talk- we did this interview earlier this morning and I promised I’d do this because I was amazed. We got a lot of calls late Friday on the show about the business of mark-ups of scripts.

And I fully understand that pharmacists and chemists have got to make a profit. I get that, and I also get that they give advice, and I think that's good. But the thing that made me jump was one of the callers, who told us that they were getting prescribed an antibiotic, and the cost of dispensing it and getting it to them was $50.

Well, I caught up with the Health Minister, and I asked him, not only that but a whole lot of other stuff.

LEON BYNER: Greg Hunt, thanks for joining us today.

Last week, we had a flurry of phone calls about the charges people are having to pay for prescriptions, and a great example was an antibiotic that's been around for damn ages, it's mainly for upper respiratory, erythromycin, where one caller says her fee to get that dispensed is $50 a script.

Now, that's a lot of money.

GREG HUNT: That's very interesting because the maximum payment for a prescription fee should be $40.30. And so we'd love to get the information. It may be that it's not a prescription medicine that she is receiving. I don't know her (inaudible)…

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

LEON BYNER: Well, erythromycin, you have to have a script. You can't get it over the counter.

GREG HUNT: Then we'd be very, very keen if your producer could provide me and my office with the details because we have concessional scripts which represent more than 90 per cent of the Pharmaceutical Benefit or prescription medicines that are made available under the PBS for $6.50, and that's the maximum fee.

And then for non-concessional, for the remaining - actually 9 per cent - it’s $40.30. So if somebody is charging more than the maximum amount that is available, then we'd be very, very keen to know.

LEON BYNER: Minister, I think the issue here is that what appears to be going on, and it's a bit like what banks have done, where pharmacists are charging the dispensing fee, but they're also adding a fee for logging it onto a particular site - it could be MyHealth, and then other things which they're adding as administrative fees.

So by the time you get your script, you're paying several times the value of the medicine itself. You aware of this?

GREG HUNT: Well the- what the Pharmaceutical Benefit Scheme does is it dramatically reduces the cost by about $10 billion to patients of medicines.

And for example today, we have new medicines for opioid dependency, new medicines for stroke, new medicines for head and neck cancer that are all being listed. In the case of head neck and cancer, it'll save patients about $250 000 dollars a year.

But in terms of the examples you've given, the rules are very, very clear that the maximum contribution for a concessional patient, which is over 90 per cent, in fact it’s about 91 per cent of all scripts issued nationally is $6.50, and for a non-concessional patient it's $40.30. So if there is a breach, then I would be very, very keen to get on with that (inaudible)…

LEON BYNER: So, let me make this clear. So that includes not just the dispensing charge, but there's a whole lot of other things that go into that as well? Are you telling me that no matter what the total, it can't be more than $40.30?

GREG HUNT: If it's a medicine that's on the PBS, $40.30 is the maximum, and again, on average, that's for about 90 per cent of scripts that are issued under the PBS around the country.

And $6.50 is the price that's the maximum for 91 per cent of scripts around the country. So that sets out a very, very clear (inaudible). And for example, Opdivo which is one of the medicines I was referring to, that would otherwise cost $250,000.


GREG HUNT: There are new variants or new uses for that which are being made available today. That would be a quarter of a billion dollars and so people have access to medicines…

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.


GREG HUNT: That they could never even dream of under the Pharmaceutical Benefits Scheme. A month ago, we've listed Kalydeco for beautiful little kids with cystic fibrosis, for 12 to 24-month children; that would have been $300,000.

So there is an enormous contribution.

What’s- so these cases are very interesting. It’s either somebody in breach or it may be a medicine which is not a government subsidised medicine on the Pharmaceutical Benefits Scheme.

LEON BYNER: Alright. Well I want to get on to somebody else who's important but before I finish on this one, community pharmacies are currently in negotiations with you guys.

Are there any consumer representatives involved in that discussion? Because I suspect that a lot of these organisations, when they negotiate, tend to make ambit claims - in other words, they asked for more than what they know they're going to get.

What can we expect out of this?

GREG HUNT: So the goal here is always to provide more services and yes, we do have the community, a range of different people who are involved in the discussion.

So it's not just with one group but you’re right to ask that and (inaudible) right to be delivering that. The goal is always to deliver more services for patients.

So for example, under the current agreement, we have what are sometimes known as Webster packs - the dosed administration aids, where for patients who might be elderly, they might have some sort of limitations, you'll have all of your week's medicine - morning, lunch, evening that are packaged up by day in a simple blister pack; might have diabetes services; we might have services that are about pain care and management of medicine.

So these are all actual community services which came from the agreement last time.

We're looking to maintain and extend those services and to make it easier and simpler to deliver.

So that's the goal. But at the end of the day, my test is always what does it actually mean for a patient in Norwood or Port Augusta? For somebody in Mount Gambier? It's always the real world. What does it mean for them?

LEON BYNER: I want to ask you know about the flu vaccinations because I know there's been a change. Now, we in South Australia, we've had a rough time this year where we've had about 25,000 flu cases reported and out of that, there’s well over a thousand deaths.

So generally, it's either the very young or the more mature and vulnerable who need to have these vaccinations. What is it that the feds are doing on this?

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

GREG HUNT: So the medical experts have finished their assessments and they've recommended that we add vaccinations for six months old babies to five year olds for flu on again, the National Immunisation Program.

We've committed to do that. So they'll be available for free for the next flu season.

This year, we've gone from about eight million vaccinations two seasons ago to 13.2 million vaccinations this year around the country. So there's been a dramatic increase.

We now have one of the highest rates of flu vaccination in the world but it's been a difficult season; there's no question about that.

We had a typical season two years ago. We had a much better, much less virulent set of outcomes last year and then this year around the world we've seen that the particular mutation of flu has been one that can be tragic, which is why we are pushing and driving up those vaccination rates and why free vaccinations for six month old babies to five year olds will be available around the nation for next flu season.

LEON BYNER: So when will that happen?

GREG HUNT: So the next flu season generally starts in about- on about the first of April. We always take the advice of federal authorities…


GREG HUNT: As to when's the optimal time to release. But it's- generally, the start of April is about the time where they determine it's the best to release the vaccination to that season.

LEON BYNER: And one final question. If a consumer goes into a chemist shop and they put in a script and they think: gee, this is damn expensive. What do you advise them to do?

GREG HUNT: Well firstly, if it's in- over and above the amount that is the agreement which is the $6.50 if you’re a concession patient or $40.30, then they should raise it immediately with the pharmacist. Now, it maybe that a particular medicine is not on the Pharmaceutical Benefits Scheme, so you'd always have to check that. And if there's a persistent breach, then to report it to the federal Department of Health. That's the important thing to do.

LEON BYNER: Minister, thank you for joining us. That’s Greg Hunt.