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Evidence-based decision-making within Australia's pharmaceutical benefits scheme
1Therapeutic Goods Administration, Australian Department of Heatlh and Aging. ruth.lopert@health.gov.au
Issue Brief (Commonwealth Fund)
|July 31, 2009
Summary
Australia
Area of Science:
- Health economics
- Pharmaceutical policy
- Health technology assessment
Background:
- Australia's Pharmaceutical Benefits Scheme (PBS) subsidizes prescription drugs.
- Evidence-based decision-making guides health technology funding.
- The PBS aims for value, affordability, and equitable access, not cost containment.
Purpose of the Study:
- To analyze the impact of cost-effectiveness considerations in the PBS on drug accessibility and the pharmaceutical industry.
Main Methods:
- Review of PBS processes and Pharmaceutical Benefits Advisory Committee (PBAC) decision-making criteria.
- Analysis of drug penetration and pricing in the Australian market.
Main Results:
- PBS inclusion relies on PBAC's assessment of comparative effectiveness and cost-effectiveness.
- Despite controversial decisions, the PBS maintains public support.
- Cost-effectiveness considerations have not negatively impacted the drug industry; Australia shows high patented medicine penetration with U.S.-level pricing for some new drugs.
Conclusions:
- The PBS effectively balances evidence-based decision-making with public access and industry engagement.
- Cost-effectiveness analysis within the PBS framework supports value for money without hindering innovation or access to new medicines.
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