Lead
Australians with multiple sclerosis will continue to receive subsidised access to three key treatments while the government and drug manufacturers work through a pricing dispute that had threatened to leave thousands of patients with annual bills of up to $33,000. Health Minister Mark Butler confirmed that Ocrevus, Kesimpta and Lemtrada would remain on the Pharmaceutical Benefits Scheme (PBS) while a rapid review is completed by the end of the year.
The announcement follows weeks of uncertainty after manufacturers Roche, Novartis and Sanofi Genzyme rejected a request to cut costs by up to 50 per cent, a move that would have applied to two of the drugs currently subsidised by the federal government.
Coverage Comparison
Two stories from ABC Australia track the evolution of the dispute. The first, published ahead of a Pharmaceutical Benefits Advisory Committee (PBAC) meeting, reported fears that 10,000 people with MS could be forced to pay up to $33,000 a year if the drugs lost their PBS listing. The second, published after the PBAC met, confirmed the drugs would remain subsidised during the review.
Both stories emphasise the high stakes for patients. The earlier report quotes MS advocates and patients warning that losing subsidised access to the "very effective" drugs would cost some people their lives. The later report notes that patients had feared being forced to privately fund prescriptions at significant personal cost.
Key Claims
Pricing dispute and threatened costs
The dispute centres on Australia's PBS pricing system, which categorises medicines by grouping different drugs that provide similar safety and health outcomes. The cheapest drug in a group serves as a benchmark price for others. The ABC reported that a third therapy, sold under the brand name Briumivi, was listed on the PBS at a substantially lower cost late last year, triggering a review of pricing for other medicines in the same group, including Ocrevus and Kesimpta. Selling those two therapies at the lower price would require a 40 to 50 per cent cost cut, which the manufacturers argued was commercially unsustainable.
The drugmakers' rejection of the initial request led to fears that as many as 10,000 MS patients could face annual costs of up to $33,000 without PBS subsidies. The ABC reported that MS advocates and patients described the potential loss of subsidised access as a matter of life and death.
Government response and patient relief
Health Minister Mark Butler said he wanted the medicines to remain on the PBS and linked the dispute with the pharmaceutical companies to changes in US policy. The ABC reported that pharmaceutical companies are increasingly sensitive to accepting lower prices overseas because the US is pursuing a "most favoured nation" policy that links American drug prices to those paid in comparable countries.
After the PBAC met, Butler confirmed that Ocrevus, Kesimpta and Lemtrada would remain listed on the PBS while a rapid review was completed. The independent committee advised that there were clinical benefits from continuing to list the drugs, and Butler accepted its recommendation to complete the review by December this year.
"The experts confirmed what the MS community has told us: that there are clinical benefits from continuing to list Ocrevus, Kesimpta and Lemtrada on the PBS to make sure these drugs continue to be available for people that need them at the PBS price," Butler said.
He added that during the review his department would work directly with the companies behind the drugs to determine what the pricing changes mean for them.