RADIO INTERVIEW: Future Proofing the PBS
Dr Fei Sim, PSA National President on ABC Radio Adelaide
1 November 2022
PRESENTER: Dr Fei Sim is the National President of the Pharmaceutical Society of Australia, good morning Dr Sim.
DR FEI SIM: Good morning.
PRESENTER: When you see the Pharmaceutical Benefits Scheme, do you think ‘this is great and God bless the person who came up with this’ or do you think it could do with some tweaking?
DR FEI SIM: I think you brought up a good point, the PBS is definitely one of the best health initiatives in the country, so I think we should all wake up every day and be thankful that the PBS is actually in Australia.
PRESENTER: Do you want to change it in any way?
DR FEI SIM: Look, I think the PBS is really good but there is always room for improvement. The key is that the PBS has to be sustainable and it has to be flexible because we live in an era where there’s constantly new medicines coming on the market, so the PBS in order to continue serving Australians I really believe that it needs to be more sustainable and flexible. The previous speaker talked about the presence of the PBAC – which is the Pharmaceutical Benefits Advisory Committee – so the government does actually have a very rigorous process, and I would consider a rather flexible process as well, to continue to evaluate whether a medicine is cost effective and whether it should be on the PBS.
PRESENTER: It must be really difficult knowing that, because you know you hear these stories about people who’ve got some horrible disease and the only thing that’s keeping them alive is some rare medication that costs a gazillion dollars to buy, but if you put it on the PBS they can suddenly buy… they can afford to live. Making those decisions must be very hard.
DR FEI SIM: Absolutely you’ve brought up another good point which is why I think the government has this rigorous process in place and the role of the PBAC is really not easy because in order to consider whether a medicine should be on the PBS there needs to be a lot of research but also economic modelling. And really it needs to be assessed on a medicine-by-medicine basis to consider if the health benefit, whether its to the few people or to the masses of Australians, whether the benefits justify the costs of subsidising the medication over and above what’s already available. So it’s definitely not an easy process.
PRESENTER: Who applied to the governing body to have a drug? Is the pharmaceutical companies or is it the medical profession?
DR FEI SIM: It often is the pharmaceutical companies, so the pharmaceutical manufacturers are often the sponsors if you like. They would have put a lot of money into research and development, and they may be researching hundreds of molecules at the one time, but often there will be a few that actually make it to the market. At the same time they actually have to apply to the TGA, to the Therapeutic Goods Administration, to actually have the medicine approved or registered to be used. Through that process they have to justify that it is safe and effective and at the same time they have to apply to have the medicine listed on the PBS from a subsidy perspective so that the Australian people can actually access the medicine in a cost effective manner.
PRESENTER: This is Dr Fei Sim, the National President of the Pharmaceutical Society of Australia.
PRESENTER: Dr Fei Sim let’s come back to you, any final comment you want to make?
DR FEI SIM: I think it’s important to highlight that it is the responsibility of every one of us living in Australia, benefitting from the PBS, to protect . For instance from the public’s perspective it’s important that we all understand that we shouldn’t be stockpiling medicines because if we actually get medicines and have them subsidized but then stockpile them at home we are actually using up the resources of the PBS when it can actually benefit others that might actually need them. At the same time, Dr Melanie Smith highlighted the importance of GP in prescribing and that is something all health professional work together . Pharmacists when we’re dispensing are using, for Trulicity as you used as an example, you know pharmacists would be actually checking the medicines that are on and through medication reviews pharmacists can also help to deprescribe, which means suggest to the GP what medicines should not be taking. All this would help to improve the judicious use of medicines which will actually help to preserve the sustainability of the PBS moving forward.
