Volume 5 • Issue 5 • October 2011
This issue - top stories
(for CHF Members only)
Prime Minister Julia Gillard with Medicines Australia Chair Will Delaat, Carol Bennett and Generic Medicines Industry Association Chair Martin Cross, at a meeting to discuss solutions to the deferrals issue.
The Consumers Health Forum of Australia (CHF) has welcomed the return to ongoing integrity and independence of the Pharmaceutical Benefits Scheme (PBS) following a decision by Government to place a moratorium on PBS deferrals for 12 months from 1 October 2011.
A statement of principles of commitment between the Australian Government, CHF, Medicines Australia (MA) and the Generic Medicines Industry Association (GMiA) released on 30 September 2011 confirms that the Government will not defer the listing of any medicine recommended by the independent Pharmaceutical Benefits Advisory Committee (PBAC) or any price increase (recommended by the Pharmaceutical Benefits Pricing Authority) over $10 million per year (in each forward estimates year) for 12 months until 1 October 2012.
CHF also welcomes a seat at the table in discussions around budget measures and future PBS policy.
The joint agreement follows a commitment from the Prime Minister, the Hon Julia Gillard MP, to work with key stakeholders to achieve a resolution (by 30 September 2011) to the dispute over the Government’s decision to defer PBS listings in February 2011.
Apart from the moratorium on deferrals, other key parts of the Agreement include:
CHF Chief Executive Officer, Carol Bennett, championed the agreement, saying that the Government had acted strategically to address key concerns around the deferrals policy for industry and consumers while retaining its right to rein in escalating cost of the PBS into the future and ensuring the sustainability of the Scheme.
“Today is a victory for ongoing consumer access to essential medicines. CHF’s membership (which represents around a million health consumers) will warmly welcome this announcement as it will restore certainty of access to affordable, subsidised medicines while maintaining the integrity and independence of the PBS – something that Australians highly value."
“Australians understand the pressure on Government to maintain fiscal responsibility while balancing the needs of the community to quality healthcare. This agreement provides both. The Government has listened and responded to the concerns of Australians while seeking to ensure the future of the PBS – a Scheme which is the envy of the world.”
Pharmacists will be prompted to sell Blackmores products by dispensary software.
The recurring question of whether pharmacists are primarily health professionals or merchants has risen again with the recent partnership announcement between the Pharmacy Guild of Australia and Blackmores. Through this partnership, pharmacists will be prompted through dispensing software to promote the sale of certain complementary medicines when consumers fill prescriptions, generating revenue for both pharmacies and Blackmores.
Guild Care, the computer software used to support dispensing, will now prompt the pharmacist (or dispensing assistant) to recommend the purchase of certain complementary products from the new Blackmores Companions range, when prescriptions for antibiotics, statins or anti-hypertensives are filled. Products in the Blackmores Companions range will also carry the Gold Cross, to signify the Guild’s endorsement of the product.
Announcing the partnership in Pharmacy News, Blackmores CEO Christine Holgate described the products as the “coke and fries” of medicines, and pointed to the “new and important revenue stream” this initiative would provide pharmacists.
National President of the Pharmaceutical Society of Australia (PSA), Grant Kardachi, said in a media release that PSA was appalled at any reference suggesting that pharmacies may become a McDonald’s style business. “The “coke and fries” quote is very unfortunate and has done great damage to the profession of pharmacy,” he said. NPS: Better Choices, Better Health has also weighed into the debate, with CEO Lynn Weekes arguing that offering a complementary medicine as a companion product to every person taking a particular prescription medicine ‘just in case’ is not best practice. NPS has released a review of the evidence for each of the products in question which is available at http://www.nps.org.au/topics/companion_products
CHF is concerned that this move represents an unethical commercialisation of healthcare and a direct violation of the PSA Code of Professional Conduct and Quality Care Pharmacy Program standards.
CHF CEO, Carol Bennett, said, “These professional obligations extend beyond serving the individual’s health, to a role which promotes the general welfare of the individual and community. Encouraging consumers to pay at least $15 for a product that has little proof of efficacy and is of questionable value clearly conflicts with this obligation. This initiative appears focussed on up-selling, not partnering with consumers and doctors for better individual and community health outcomes."
“Pharmacists are trusted professionals in the community. If they want to retain this trust and confidence and demonstrate their right to the substantial, taxpayer-funded $15 billion Community Pharmacy Agreement between the Guild and the Government, they need to deliver quality, cost-effective services to Australian consumers. That means acting in their best healthcare interests, not pushing additional products that have questionable benefits onto consumers just to make more money,” Ms Bennett added.
5 October - The Pharmacy Guild and Blackmores announced that the agreement would not proceed, citing ‘a strong level of public concern about the proposal.’ CHF welcomed this move in a media release.
“Government action to deal with the advertising, promotion and labelling of prescription, non-prescription and complementary medicines is long overdue and needs to be implemented as a matter of some urgency”, said CHF CEO Carol Bennett.
Ms Bennett was commenting after the release of a report by the Australian National Audit Office (ANAO) critical of the regulation of complementary medicines in Australia. The report has created further pressure for a tightening of controls in an industry worth over $1.2 billion dollars annually.
The ANAO report, released after a six month investigation, reinforces many of the concerns that have been raised by consumers with CHF in recent years and have been the subject of numerous reviews dating back at least a decade.
Figures released by the Department of Health and Ageing (DOHA) earlier this year found that as many as 90 percent of the small percentage of complementary health products reviewed by the Therapeutic Goods Administration (TGA) were “found to be non-compliant with regulatory requirements.”
Commenting on these statistics, the ANAO report said “...the available evidence indicates that the regulation of complementary medicines in Australia has been of limited effectiveness”.
“It is clear from this audit that a major overhaul is needed of the regulatory and legal framework dealing with the 10,000-plus complementary products on the shelves of supermarkets, pharmacies and health food stores,” said Ms Bennett.
“While it is heartening to see that the Department of Health and Ageing has agreed with the major recommendations of the ANAO, one would have to wonder why it has taken successive Governments so long to deal with this problem and other issues relating to promotion and advertising of therapeutic goods that have been self-evident for many years,” she added.
CHF has been involved in many key inquiries including the reviews into TGA transparency, complementary medicines, promotion and advertising, packaging and labelling, and health technology assessment.
For complementary medicines, CHF has called for government action in three areas by:
“The issues outlined in the report reflect the findings and recommendations of recent CHF research into consumer views on complementary medicines,” Ms Bennett said.
“We hope the Government will proceed to address these issues as a matter of urgency so that the many Australians spending their hard earned cash on these products can make better informed decisions,” she added.
CHF has continued to lobby for consumers at the highest levels of Government, participating recently in three Senate Committee inquiries considering the new Independent Hospital Pricing Authority, the Professional Services Review Scheme and the regulation of medical devices in Australia.
CHF provided a submission to the inquiry into the legislation to establish the new Independent Hospital Pricing Authority, and CHF CEO Carol Bennett and Senior Policy Manager Anna Wise provided evidence to the Committee on 7 September 2011. CHF’s submission and evidence emphasised the importance of consumer involvement in the new body and called for this to be included in the legislation, arguing that this new health reform body’s composition should reflect the emphasis on consumers at the centre of healthcare that has pervaded health reform debates. Responding to the release of the Committee’s report, Ms Bennett said, “While we were pleased to see our evidence quoted extensively throughout the report, it is disappointing that the Committee’s recommendations do not reflect the centrality of consumers that has been at the core of health reform”.
On 23 September 2011, Ms Bennett and Ms Wise gave evidence to the inquiry reviewing the Professional Services Review (PSR) scheme, arguing that the checks and balances provided by the PSR scheme protect consumers from inappropriate use of the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme. In her evidence, Ms Bennett said, “While we consider that a review is timely, we would be concerned at the introduction of any changes which stymie the efforts of the PSR to protect the community from inappropriate practice and deter poor practice in the future. And consumers must be at the table in any reviews or reforms of the PSR system.”
Consumer views on the regulation of medical devices in Australia were presented to a Committee hearing on 27 September 2011 by Ms Bennett and CHF Board Member, Karen Carey. CHF’s evidence emphasised the importance of rigorous post-market surveillance mechanisms to protect consumers, including through the implementation of recommendations 13, 14 and 15 of the Review of Health Technology Assessment in Australia. The arguments made by CHF reflected concerns raised by consumers at CHF consultations, including at the recent workshop prior to the Joint Medicines Policy Conference, that the Government is yet to resource and implement key recommendations of the HTA Review and the TGA transparency review that would improve adverse event reporting and post-market surveillance.
“We are pleased that CHF’s views on major health policy continue to be valued, as is demonstrated by our regular invitations to appear at Senate Committee hearings,” Ms Bennett said. “We will continue to contribute to these important review processes to ensure that the voices of consumers are heard and taken into account.”
|Minister for Health and Ageing, the Hon Nicola Roxon MP with Emily Anderson, Alison Gaffney, Dr Clare Seligmann, Paige Armstrong, Keith Fell, Vonda Moar-Malone|
Health consumer and community leaders from around Australia shared expertise and ideas on how to engage with consumers and local communities to improve healthcare at a national workshop hosted by CHF in Canberra, 14-15 September 2011.
In a dinner address, the Minister for Health and Ageing, the Hon Nicola Roxon MP welcomed the commitment by these healthcare leaders to connecting and working with consumers and the community.
Minister Roxon said that, “from the beginning, one of the key objectives of the Government's health reform agenda has been to bring the consumer back into the centre of the health system”. She went on to say that “Medicare Locals offer a particularly strong opportunity to enhance consumer involvement” and that the challenge for those involved in Local Hospital Networks (LHNs) “is to ensure that you establish effective mechanisms to communicate with consumers in your communities to get their involvement and then to act to respond to their concerns”.
The workshop, facilitated by Dr Norman Swan, is the first in a series to provide high-level networking, skill-development and knowledge sharing forums for consumer and community members appointed to the Boards and Governing Councils of LHNs and Medicare Locals. Many Chairs and Chief Executive Officers accepted CHF’s invitation to attend the first day.
“Consumers are partners in healthcare and the consumer perspective can be a key contributor to improving healthcare planning and policy. We need to move beyond tokenism and create organisational culture and operational practice that embeds consumer engagement, not as an extra thing to do, but as a way to get things done,” said CHF Chair, Stephen Murby.
Click to view a special report on the workshop. Further background, slides from some of the presentations and the Minister’s address are available at www.chf.org.au in the section devoted to the CHF Our Health, Our Community Project.
The CHF Our Health, Our Community Project is funded by the Australian Government Department of Health and Ageing
CHF wants to see the public release of long-term governance plans for the lynchpin of the proposed national eHealth system, the Personally Controlled Electronic Health Record (PCEHR).
CHF’s comments come following the release of the detailed Concept of Operations Relating to the Introduction of a Personally Controlled Electronic Health Records Systemby the Minister for Health and Ageing, the Hon Nicola Roxon MP.
While welcoming the release of Concept of Operations, CHF is concerned about the removal of consumer controls to limit access to information. CHF and its members are particularly concerned about the lack of long-term governance arrangements for the PCEHR system, and the reluctance of decision-makers to consider a move from the proposed opt-in system to an opt-out system that will provide opportunity for consumer control at key decision-making points.
CHF and its members have become increasingly supportive of the concept of an opt-out system, based on evidence that the full value of the PCEHR system will not be achieved unless there is widespread adoption across the population. CHF has reviewed research into the Summary Care Record in the United Kingdom, which shows that clinicians are unlikely to use eHealth records unless there is a critical mass of users.
CHF also has deep reservations about the fact that no detail has been provided about what the long-term governance arrangements for the PCEHR system will be. CHF maintains that the governance structure must be subject to consultation. Given that the 1 July 2012 deadline for implementation is looming, this must be done as a matter of urgency.
The Concept of Operations notes the widespread concern about both of these issues, but deems them to be out of the document’s scope.
CHF is preparing a response to the Concept of Operations, which calls for the development of a governance model for consultation and reconsideration of the opt-in model. CHF’s response also explores consumer access controls, the management of PCEHR information and the privacy and security of consumer information.
The Concept of Operations is available at http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehr-document. CHF’s response will be available soon at www.chf.org.au
The Government has also released exposure draft legislation to support the PCEHR system. CHF welcomes the release of the exposure draft legislation, and will review it in detail to assess whether it will address all the concerns of consumers. CHF will be providing a detailed submission. The exposure draft legislation is available at http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehr-legals.
Parliamentary Secretary for Health and Ageing, the Hon Catherine King MP, with CHF Chair Stephen Murby.
A series of important recommendations to improve consumer engagement and information about medicines and health technologies were developed at a CHF/Medicines Australia workshop in Canberra at the end of August.
The workshop, opened by the Parliamentary Secretary for Health, the Hon Catherine King MP, was held prior to the Third Joint Medicines Policy Conference (JMPC).
The CHF workshop involved some 30 consumer representatives, CHF staff, and senior representatives from the Department of Health and Ageing, Medicines Australia, the Therapeutic Goods Administration, the Australian Medical Association, the Medical Technology Association of Australia and the Royal Australasian College of Surgeons.
The workshop focused on recent health reforms and the HTA Review while exploring the importance of collaboration and consumer engagement in the development and implementation of reform. Findings from the pre-conference workshop were presented by CHF CEO, Ms Carol Bennett, in the opening session of the JMPC.
CHF Chief Executive Officer Carol Bennett said the workshop proved to be an invaluable vehicle for the exchange of consumers’ ideas and concerns and that recommendations emerging from it, if fully acted upon, would improve the level and quality of information available to consumers.
Workshop speakers: Brendan Shaw (Medicines Australia [MA]), Anne Trimmer (Medical Technology Association of Australia), Rohan Hammett (Therapeutic Goods Administration), Deborah Monk (MA), Stephen Murby (CHF), Wendy Babidge (Royal Australasian College of Surgeons), Carol Bennett (CHF), Ken Harvey (LaTrobe University), John Aloizos (Australian Medical Association), Will Delaat (MA).
CHF CEO Carol Bennett addresses Joint Medicines Policy Conference delegates.
“Consumers stand where the rubber meets the road – those ultimately affected by the decisions and priorities in HTA are consumers. They fund the system, they use the system and they rely on the system to achieve better health outcomes,” said CHF CEO, Carol Bennett.
Ms Bennett was speaking at the opening session of the Third Joint Medicines Policy Conference, held in Canberra on 30 and 31 August 2011.
In her presentation, Ms Bennett called for consumers to be at the centre of the development and implementation of Health Technology Assessment (HTA) initiatives. Consumers want input into all aspects of design, delivery, monitoring and reporting on the system, and a range of methods for including consumer views and experiences – for example, consumer impact statements, citizens juries, consumer advisory councils, internet surveys and active monitoring – could be used to achieve this. However, Ms Bennett identified a number of excuses that are currently used to delay the implementation of these initiatives.
“We are suffering from systems inertia, adding onto our existing system incrementally rather than making the wholesale change we need,” Ms Bennett said.
“The reality is that if you start where the system is now rather than focusing on what consumers need and want, the system simply won’t work for consumers.”
Ms Bennett also emphasised the importance of effective adverse event reporting and post-market surveillance systems for consumers, calling for the urgent implementation of HTA Review recommendations that would improve these systems for consumers.
“If we put consumers at the centre of the system, we will all benefit – Government, health professionals, industry and all Australians. Consumers are ready and willing to assist with this essential work. All we need to do is give them the tools!” Ms Bennett concluded.
CHF’s new clinical trials factsheet.
A CHF-prepared factsheet explaining the system and benefits of clinical trials in Australia has received positive support from consumer organisations and industry and will be widely distributed around Australia.
The factsheet is a joint initiative with the Federal Government and was inspired by the Clinical Trials Action Group (CTAG) established in 2009 with the aim of identifying and progressing necessary reforms to secure Australia’s competitiveness in the clinical trials sector.
A report by CTAG in March this year – Clinically Competitive: Boosting the Business of Clinical trials in Australia – outlined a series of recommendations for Government, including improving access to information on clinical trials for consumers. CHF was involved in this review.
The Department of Innovation, Industry, Science and Research funded CHF to develop a factsheet aimed at consumers, and developed with input from consumers, to provide clear, trustworthy information on clinical trials.
After consulting widely with consumers on content and formatting, a factsheet was developed that aims to provide consumers with a basic understanding of clinical trials, including the benefits and risks of participating in a clinical trial.
It was launched publicly at the Third Joint Medicines Policy Conference in Canberra at the end of August. The factsheet is available online, in both colour and print-friendly versions at https://www.chf.org.au/clinical-trials-project.php.
Expert panelist on The Australian's Health of the Nation Roundtable: Prof Stephen Leeder, CHF CEO, Carol Bennett, Prof Philip Davies, Prof Christine Bennett,Prof Mohamed Khadra and Dr Sue Page.
CHF CEO Carol Bennett provided a strong consumer voice in a high powered expert panel convened by The Australian newspaper to discuss “The Health of the Nation”.
The panel was convened to discuss the most pressing challenges facing Australia’s health system and the progress the country is making in addressing them.
Issues discussed by the panel (the results of which will appear in a publication in October) included health costs and affordability, access to health services, governance in the new health reform environment, drug policy, the role of the private sector, and systemic issues related to the costs of new procedures and medicines.
Also involved in the panel were Professor Christine Bennett, who chaired the National Health and Hospitals Reform Commission; Professor Philip Davies, School of Population Health, University of Queensland; Prof. Mohamed Khadra, University of Sydney; Professor Stephen Leeder, Director of the Menzies Centre for Health Policy; Dr. Sue Page, former President of the Rural Doctors’ Association; and Professor Robyn Ward, a member of the Pharmaceutical Benefits Advisory Committee.
The Australian is currently running a series of articles on health in its weekend edition.
For the second year in a row CHF is supporting the Financial Review National Health Conference. The conference is a dynamic one day forum for health sector leaders to come together and discuss the future of the sector. The conference will assess whether the government is doing enough to match its aspirations with action and funding.. To register for this event and receive your "Industry Association" discount please visit www.afr.com/events
Former PBAC Chair Lloyd Sansom has stepped down after 10 years in the role.
Emeritus Professor Lloyd Sansom AO has recently stepped down from the position of Chair of the Pharmaceutical Benefits Advisory Committee (PBAC), after ten years in the role. CHF valued the high standards set by Professor Sansom in ensuring that the latest and most effective medicines are assessed for value and efficacy before being recommended for subsidy on the Pharmaceutical Benefits Schedule. CHF also appreciated the efforts of Professor Sansom to incorporate consumer input into the PBAC process.
Writing about his time as PBAC Chair in an article in the soon-to-be-released October edition of CHF journal Health Voices, Professor Sansom thanked all the consumers with whom he had interacted during his time on the PBAC, and, earlier, the Australian Pharmaceutical Advisory Council, saying, “It has been an absolute pleasure to have worked with you to promote the role of the consumer in pharmaceutical policy development, evaluation and implementation”.
The new PBAC Chair will be Dr Suzanne Hill, who brings a wealth of Australian and international experience to the position.
The Consumers Health Forum of Australia Inc (CHF) is the peak organisation providing leadership in representing the interests of Australian healthcare consumers. We work to achieve safe, good quality, timely healthcare for all Australians, supported by the best health information and systems the country can afford.
CHF member organisations reach Australian health consumers across a wide range of health interests and health system experiences. CHF also supports the appointment of consumer representatives to national health-related committees.
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