Assistant Minister for Health and Aged Care, speech - 10 September 2024

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• Good evening, it’s great to join you for PharmAus here in Parliament House.
• I would like to acknowledge the traditional custodians of this land – the Ngunnawal and Ngambri Peoples and pay my respects to Elders past and present, and all First Nations people joining us today.
• I bring with me the apologies of the Minister Mark Butler, who planned to be standing here with you tonight, but has come down with an illness.
• I know that Mark really wanted to be here at this particular PharmAus, because it is a big day for the sector and for the country.
• Today we publicly released the final report of the Health Technology Assessment Policy and Methods Review.
• The HTA Review was a key commitment of the current Strategic Agreement between the Commonwealth and Medicines Australia.
• The HTA Review Report has clearly been an enormous piece of work. 
• The numbers only begin to give a sense of the scale of it:
  • 50 recommendations
  • Over 200 pages of analysis
  • 2 public consultations
  • Over 250 submissions 
  • And 28 deep dive discussions with experts and other groups.
• All of that work was overseen by a Reference Committee that represents the views of experts and patient organisations, First Nations peoples, scientific and clinical practice, and of course the industry and government. 
• I want to thank the Reference Committee: 
  • Debora Picone
  • Dawn Casey
  • Ann Single
  • Andrew Wilson
  • Andrew Roberts
  • Adriana Platona
  • and, of course, Liz De Somer from Medicines Australia.
• Their expertise, dedication and tireless work has been instrumental in delivering what is a generational review of Australia's system of health technology assessment.
• Everyone in this room recognises the life changing power of medicine and health technology, but sometimes it feels easy to get lost in scientific terms, side effects and percentage stats about different cohorts.
• I know there are people here at this PharmAus event who are the geniuses behind little pills and big devices, that will make people live to their 90^th birthday, that can keep kids out of hospital, that will give people abilities back and can support a vaccinated and healthier whole population. 
• Let me, from the bottom of my heart, thank each and every one of you for the work you do, and the innovations you champion, that improve the lives of Australians.
• One of the other special items I know is here right now is an extraordinary ‘meno-vest’ so that men can experience the delights of a menopausal hot flush.
• Now, the HTA Review Report is being released into a context of great change across the Australian health and aged care sector.
• When we came to government after a decade of cuts and neglect, and a once-in-a-century pandemic, the need for investment and reform had become urgent and acute.
• Our work to strengthen Medicare means the sector will very soon have before it a number of large reviews, looking at everything from:
  • the incentives we provide to GPs and general practices,
  • where in the country we ask health professionals to work, and 
  • what care they are allowed to perform in their scope of practice.
• On hospitals ... a lot of work has been underway to secure a new five-year agreement with states and territories for hospital funding, which will see at least 13 billion additional dollars flow to public hospitals from the Commonwealth.
• But we want that agreement to be much more than its predecessors – going back to when we were last in government – very technical documents that set out the basis for activity-based funding and how that financing system would work.
• We want it to live up to its name and be a genuine National Health Reform Agreement, which takes a whole-of-system perspective, as the former Dep Sec of Health and Secretary of Finance Rosemary Huxtable certainly recommended, in her very fine midterm review of the existing agreement.
• The final agreement will deliver further integration of our – too often – fragmented health system: ensuring that hospitals, aged care, disability care and general practices are working much more effectively together to get better outcomes.
• In the health and medical research space, where Australia well and truly punches above its weight, the Government and the sector are developing a single National Health and Medical Research Strategy for Australia, which will be a first for this country.
• At a time where we are investing more money into health and medical research, a single national strategy will help ensure that money is invested in absolutely the right directions. 
• We also invested $19 million in this year's Budget, to further the work that Professor Ian Chubb has led, to create a One Stop Shop for clinical trials in Australia - and I can't overemphasise the importance of this. 
• There are great things about being a Federation. 
• In my home city of Melbourne, we all watch, with some amusement, the creative tension generated by Australia’s second city – Sydney – trying to live up to Melbourne’s example as the research capital of Australia.
• But there are also some great inefficiencies, as I'm sure many people in this room tonight would know all too well.
• And these inefficiencies are well understood over the course of our nation's history, whether it's railway gauges or licensing schemes and so much else that really hold back businesses, researchers, universities and the like. 
• Clinical trials have been exactly that problem.
• To do a multi-jurisdiction clinical trial in this country - for many, many years - industry, researchers, universities have complained about the need to get approvals in every single jurisdiction. 
• This is an inefficiency that - at best - delays and duplicates, and - at worst - deters investment entirely.
• None of these reviews, none of this change and upheaval, exists in a vacuum.
• Change in one part of the health system has flow on impacts in the others.
• This is the context into which we release the HTA Review Report - another generational report that recommends reforms that are major, complex and with wide-reaching impacts on the healthcare system, on industry and - most importantly - on Australian patients.
• Of course, the HTA Review Report follows on from The New Frontier Report, an excellent and far-reaching piece of work, championed by two people who I expect are here tonight, Trent Zimmerman and Dr Mike Freelander.
• Throughout his many years in medicine, Dr Mike has probably seen quite a number of new frontiers come and go.
• Dr Mike understands, perhaps more than most in this building, how much health and medicine has changed and how that pace of change is growing year after year after year.
• We are living in a supercharged period of discovery, and it is bringing with it the promise of better health.
• And with change comes challenge.
• The velocity of that change is stress testing every part of the health sector, from clinical practice, to business models and government budgets.
• It is also, of course, stress testing our system of health technology assessment, which the HTA Review Report makes so glaringly clear.
• Immunotherapies like CAR T cell therapy, for instance, are already stretching the bounds of our traditional systems and processes.
• Delivered in state and territory hospitals, with funding from the Commonwealth and approval by federal MSAC processes, these new therapies stretch across jurisdictional boundaries and may not fit neatly into our existing systems for approving and subsidising health technologies.
• CAR T is just the beginning… coming down the line we also see:
  • many more gene edited cell-based therapies,
  • new screening technologies to rapidly test whether existing medicines can treat previously untreatable conditions, and
  • mRNA therapies that use the body’s own systems to manufacture the treatment it needs. 
• These are just some of the new frontiers in medicine that are speeding towards us.
• Which is why the HTA Review is just such a critical and groundbreaking piece of work.
• It brought together experts in clinical and scientific fields along with representatives of industry and public administration to chart a course - a truly generational course - towards this future of better health, better health technologies, and better health technology assessment.
• The HTA Review Report is a consensus report that distils all of the wisdom, analysis and experience of those experts on the Reference Committee, along with the hundreds upon hundreds of hours of work that went into the many hundreds of public submissions, deep dives, and public consultations.
• The 50 recommendations in the HTA Review Report are both far reaching and wide ranging.
• Some are small, focused prescriptions for change that are limited in scope, and eminently sensible. 
• Others are wide ranging and visionary and call for changes in legislation and new investment.
• Recommendations like a bridging fund to help patients get faster access to the most high value medicines and treatments. 
• So that when the need is urgent and the benefits are clear, red tape and bureaucracy are no barrier between a patient and sometimes life saving treatment. 
• There are recommendations that will improve equity, to ensure that the experience and voice of regular people helps to shape the way they access medicines and therapies. Particularly so the needs of First Nations people and also children, can be better met. 
• There are recommendations that seek to solve problems that have been longstanding both here in Australia and overseas. 
• Solutions for problems that could quite reasonably be said to arise from market failure, like in the space of antimicrobials, where the current system does not sufficiently reward and incentivise the development of new antimicrobials.
• There are recommendations to update PBAC guidelines to clarify what therapy should be selected as the main comparator when assessing a health technology.
• The HTA Review Report is farsighted enough to be visionary, while being firmly grounded in the practicalities of the here and now.
• In formulating the Government response, Minister Butler will be engaging and consulting with the experts at PBAC and MSAC, state and territory health ministers, and of course, with Medicines Australia, who have always been forthright advocates for this Review and for improvements to our systems of health technology assessment.
• Of course, Minister Butler will also be consulting with consumer and patient groups, who have - too often - been excluded from our HTA system. 
• Because in this - as in everything we do as a government - our North Star is and always will be: patient benefit.
• Which is why today, we also released the companion report to the HTA Review, the “Enhance HTA Report”, which delivers ten recommendations to elevate the consumer and patient voice in our health technology assessment processes.
• The recommendations were co-designed by a multi-stakeholder consumer led working group representing patients and consumer organisations, the industry and government.
• Minister Butler has asked me to thank the Chair Sharon Winton and all the members of the working group, many of whom are here today – and in particular the consumer representatives:
  • Karen van Gorp
  • Nicole Millis
  • Cara Philpott
  • and Genevieve Handley.
• You have all helped to keep this review down to earth and relevant for Australia’s 26 (or so) million people. 
• The goal of the HTA Review is faster access to the best therapies, at a cost that patients and the community can afford.
• And today’s release of this crucial report, brings us one step closer to that ambitious reality. 
• Value for money remains paramount, because value is at the heart of patient benefit.
• With health technologies, the opportunity cost of a dollar spent needlessly or on the wrong therapy is enormous.
• That opportunity cost isn't measured in dollars and cents, but in months and years.
• In time lost with loved ones, in contributions to family and community that are never made, in future achievements that never come to be.
• Every dollar spent on a medicine that is no longer best in class, is a dollar that doesn't get spent on one that is.
• Every dollar spent on a treatment that isn't cost effective, is a dollar that doesn't go to treatments that are.
• Every dollar spent on a therapy that delivers only marginal benefit, is a dollar not spent on a truly lifechanging one.
• Of course, delays and duplication in health technology assessment also impose opportunity costs, as well.
• A month with negotiations at an impasse is a month that patients are without that therapy. 
• Months matter.
• Good reform matters.
• Landing this good reform will take time, just as it will take the collective effort of governments, experts, patients and industry.
• A good reform must be jointly owned.
• The Government will establish an implementation group to guide the reform process and provide regular updates to Government. 
• This independent group will be led by an eminent Australian and will include representation from the Commonwealth and state and territory governments, as well as industry, consumers and clinicians, as well as the expertise of a health economist.
• It is fitting that one of the recommendations of the HTA Review is for jointly owned performance targets.
• As a government, we’d like landing this good reform to be our first jointly owned performance target.
• I invite you to join us in working towards that target.
• Our work towards it begins today.