Australian patients are waiting over 18 months to receive subsidised access to new cardiovascular medicines, far longer than in many comparable countries, new figures show.
There are calls for more to be done to fast-track the process for PBS approvals amid claims patients are being forced to dip into superannuation to access treatment.
Analysis by industry group Medicines Australia shows it takes an average of 528 days for a cardiology drug to get on the PBS after being registered with the TGA.
Other therapy areas where drugs face prolonged average wait times for PBS listing include cancer, arthritis, asthma/COPD and mental health, while vaccines typically take over three years to get the nod.
Therapy area | Average wait for PBS listing | Number of registered products |
Arthritis | 227 days | 12 |
Asthma/COPD | 219 days | 8 |
Cancer | 496 days | 56 |
Cardiovascular | 528 days | 8 |
Diabetes | 376 days | 9 |
Hep C | 295 days | 11 |
Mental health | 361 days | 5 |
Others | 376 days | 80 |
It says in other developed countries, 60% of medicines are reimbursed within six months of registration, compared with only 22% in Australia.
The lobby group pointed to figures showing 80 medicines registered in Australia between 2015 and 2020 still had not received PBS listings.
All up, there were currently 21 cancer drugs and seven other medicines being reimbursed in other OECD nations but not in Australia, Medicines Australia said.
Among them were the cancer drugs Cyramza (ramucirumab) and Ninlaro (ixazomib) which had been subsidised in 17 and 14 OECD countries respectively.
Notably, Cyramza remained off the PBS despite having been recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) in March 2018.
AMA vice president Dr Chris Moy said that although the Federal Government had promised to subsidise every medicine recommended by the committee, there were still major delays while bureaucrats haggled with drug companies over price.
“The delays come from a combination of things and to be fair to the government, it’s ultimately a matter of resources,” he said.
“Nevertheless, the process can take an inordinately long time.”
Clinical Oncology Society of Australia president Professor Fran Boyle said that with cost a major factor in government decision making, many medicines faced an uphill battle to gain funding.
“Drugs for early disease tend to struggle, as do those with co-dependent assessments to have a test approved as well,” she said.
“The third group are drugs that have not been trialled in Australia and are not owned by one of the usual local big pharma companies with the experience to take it through the system.”
“We see that with quite a few of the drugs coming out of Japan and China at the moment.”
Professor Boyle, the medical oncology chair at the University of Sydney’s Northern Clinical School, stressed there were sometimes workarounds for clinicians able to sign patients up for drug trials or other access schemes.
But this was not always possible, particularly for patient’s in rural areas and those with diseases that lacked active consumer organisations, she said.
“Things have improved though compared to what they were 20 years ago and we’re far better now than New Zealand for example,” she added.
“We have seen increasing transparency and public reporting of the deliberations of the Pharmaceutical Benefits Advisory Committee as well as the development of a rapid re-entry process for drugs with data that is not controversial but have previously been rejected on cost grounds.”
Medicines approved for use in Australia but yet to receive PBS listing*
Product | Molecule | Therapy area | Number of other OECD countries reimbursed | Launched in Australia | Registration Year |
PIQRAY | ALPELISIB | Cancer | 7 | No | 2020 |
ERLEADA | APALUTAMIDE | Cancer | 13 | Yes | 2018 |
SUNVEPRA | ASUNAPREVIR | Hepatitis C | 2 | Yes | 2015 |
CABLIVI | CAPLACIZUMAB | Cardiovascular | 10 | No | 2020 |
VRAYLAR | CARIPRAZINE | Mental health | 13 | No | 2020 |
LIBTAYO | CEMIPLIMAB | Cancer | 8 | No | 2020 |
NORAVID | DEFIBROTIDE | Cardiovascular | 10 | No | 2020 |
UNITUXIN | DINUTUXIMAB | Cancer | 9 | No | 2020 |
EMPLICITI | ELOTUZUMAB | Cancer | 13 | No | 2016 |
IDHIFA | ENASIDENIB | Cancer | 1 | No | 2020 |
BRAFTOVI | ENCORAFENIB | Cancer | 15 | Yes | 2019 |
XOSPATA | GILTERITINIB | Cancer | 9 | No | 2020 |
TRESIBA | INSULIN DEGLUDEC | Diabetes | 10 | No | 2017 |
SARCLISA | ISATUXIMAB | Cancer | 9 | No | 2020 |
NINLARO | IXAZOMIB | Cancer | 14 | No | 2016 |
VITRAKVI | LAROTRECTINIB | Cancer | 8 | No | 2020 |
NERLYNX | NERATINIB | Cancer | 7 | No | 2019 |
ZEJULA | NIRAPARIB | Cancer | 14 | No | 2019 |
FARYDAK | PANOBINOSTAT | Cancer | 11 | No | 2016 |
POLIVY | POLATUZUMAB VEDOTIN | Cancer | 8 | No | 2019 |
CYRAMZA | RAMUCIRUMAB | Cancer | 17 | Yes | 2015 |
ULTOMIRIS | RAVULIZUMAB | Cancer | 6 | No | 2019 |
CINGAIR | RESLIZUMAB | Asthma/COPD | 12 | No | 2017 |
QINLOCK | RIPRETINIB | Cancer | 1 | No | 2020 |
KEVZARA | SARILUMAB | Arthritis & Psoriasis | 14 | No | 2018 |
TALZENNA | TALAZOPARIB | Cancer | 9 | No | 2019 |
IMLYGIC | TALIMOGENE LAHERPAREPVEC | Cancer | 8 | No | 2015 |
TUKYSA | TUCATINIB | Cancer | 1 | No | 2020 |
(*source: Medicines Australia)