The 'Dispatched' Podcast

This week's discussion concerns transparency, or the lack of in policy development processes, and how it leads to highly curated outcomes that rarely benefit public health programs and the people they are designed to serve.

We discuss what has been a hectic week, to say the least, where to from here, and the implications against the backdrop of a complex and highly uncertain period ahead.

This week in review is titled 'you can't make this up' as we focus on the lack of transparency and openness on two critical processes and the excuses to justify the secrecy. We also discuss interesting news about the 16 referrals for potential breaches of the APS Code of Conduct following the release of the robodebt royal commission report.

We answer your questions today, with each of us producing our own list of five positive things about the PBS, but also the opportunities for reform. 

New Zealand's Pharmac looks forward to sharing its model with counterparts in Australia, the UK and Canada, the parliament is considering new laws that will force one group of families into a very difficult and unfair decision that could have implications for every patient advocate, the government has released its long-awaited 'well-being index', and we answer your questions.

Why should everyone be concerned by the obsession with secrecy over a public health program, the wider lessons from the 'Royal Commission into the Robodebt Scheme', and the reality that a status quo approach to policy change is doomed to fail?

The secret involvement of Pharmac in the international HTA collaboration, why it has no place in any process that could impact patients anywhere in the world, and why industry and patients need to act to urgently block the 'dark arts' spread of its terrible ideas.

Why are some people so sensitive to criticism of health technology assessment? What does it reveal about the decision-making culture, and why must it be confronted? Tomorrow will see a long-awaited change for one group of marginalised patients. What does it mean, why is it important, and what does it reveal and the challenge of advocacy and securing change?

Health technology assessment and why systems have it so wrong when it comes to patients and decision-making. The latest on the reform of the Opiate Dependence Treatment Program and why the compulsory acquisition of a hospital in Canberra highlights everything wrong with policy development.

A different approach this week with the discussion looking ahead to the end of June, with published outcomes expected on requests for relief from the stockholding commitment, detail on reform of the Opiate Dependence Treatment Program, and lots of discussions on health technology assessment.

Parents are showing remarkable courage in sharing their personal stories of loss in an attempt to convince the Albanese government to implement a pre-election commitment. A typo means the planned diabetes tender will proceed simultaneously with the recently announced parliamentary inquiry. How? Are 60-day dispensing and other changes going the same way as other recent reforms?

We focus on the Administrative Appeals Tribunal's negative reflections on the health department, the minister's criticism of 'clunky' HTA, and rugged exchanges at Budget Estimates between senators and officials on various issues, including 60-day dispensing and newborn screening.

Thoughts on the recent BPD annual conference and the latest on the dispute between the Albanese Government and pharmacy over the plan to increase dispensed quantities of over 300 medicines, including an interesting rumour. Readers' questions on a difficult discussion and next week's Senate Estimates hearing.

The 'Week in Review' was recorded at the BioPharmaDispatch annual conference and featured Cube's Anne-Marie Sparrow and Jody Fassina of Insight Strategy. We discuss the 2023-24 Budget, the ongoing fallout over the plan to increase dispensed quantities, and the range of other issues raised at Monday's event.

The 2023-24 Budget has revealed significant growth in the PBS in the current year. We unpack the numbers and discuss what might be driving potentially transformative growth. Health minister Mark Butler also announced reform of access arrangements for medicines for opiate dependence and nicotine e-cigarettes.

In a special pre-Budget episode of the 'Dispatched' week-in-review podcast, we discuss the Albanese government's move on pharmacy, how it reflects a broader policy malaise, good news for people living with opioid dependence but not so good on newborn screening, and why disability advocates should be worried if the PBS is going to be the new model for managing growth in the NDIS.

The Albanese Government is now in a fierce fight with the Pharmacy Guild over the plan to double dispensed prescription quantities for 325 PBS-listed medicines. Pharmacy will chip away at this issue over the next few months. What does that look like, and where does it  go?

Culture and capability have been the focus this week. Will new leadership lead to change? Pre-Budget announcements are now coming 'thick and fast' but what else might we expect? We respond to questions from the audience about 'secrecy' and why the absence of celebrations about the 75th anniversary of the creation of the PBS?

The health department is about to get new leadership, which means change, hopefully leading to less of a 'smash and grab' approach to policy development. The upcoming 2023-24 Budget may not include specific new savings measures, but that does not mean they're not in there.

All questions from the audience today. Questions about what the government might want from the HTA review, 'conditionality' versus the 'managed access program', and why the tinkering on patient input to decision-making?

Any late-breaking news on the 1 April catch-up statutory price reductions? What is happening with the Albanese government's commitment to expanding Australia's patchwork of newborn screening programs? Questions from the audience about what next on pricing policy, whether it would be unfair, and what lessons can be learned.

Any surprises on the finalised terms of reference for the HTA review? The very clever politics of a 'supply only' arrangement and why the term 'commercial viability' confuses patients and masks the truth of changes that 'cut too deep'.

A change in the membership of the federal government's HTA review reference committee. What does it say about the review and what does it mean? Still waiting for final outcomes ahead of the 1 April price changes and a question from the audience about what patients can do to ensure their voices are heard.

Should we make this podcast 'confidential' by saying it's confidential? The Albanese government's unprecedented decision to release the rules for its first Budget. Could the industry be 'approached' ahead of this year's Budget given the challenging fiscal circumstances and the consistent focus on the need for savings?

Some companies are being paid a premium to keep their medicines on the PBS and well supplied while others are having their prices slashed to the point they are exiting the program. Is anyone else confused? And, why Ernest Hemingway provides the best metaphor for how people should approach the period ahead - the fisherman, the marlin and the shark.