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Doorstop interview about new medications added to the PBS for heart disease and ADHD

Read the transcript of a press conference with Minister Hunt on 31 January about new medications added to the PBS for heart disease and ADHD, EOI open for pharmacies to join vaccine workforce and COVID-19 update.

The Hon Greg Hunt MP
Former Minister for Health and Aged Care

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Tomorrow will represent a year to the day since we closed the borders with China. It was one of the most important decisions that has been taken. I believe one of the two most important decisions.

The other one was to engage CSL for onshore manufacturing of the COVID vaccine. And throughout the course of that year, pharmacists have done a magnificent job.

As part of that I’m delighted to be joined by George Tambassis, the President of the Pharmacy Guild of Australia, and then the owners of this pharmacy here in Mount Martha: John-Paul, who’s behind me, Joseph and Cathy. They and their team have just served the community during the height of the lockdowns and kept the medicines flowing and kept the advice available.

One of the critical things that pharmacists do is to dispense medicines under the Pharmaceutical Benefits Scheme.

The PBS is a national asset, it’s one of the most important things we do as a government, and I am delighted today to announce two new medicines that will be available on the Pharmaceutical Benefits Scheme as of tomorrow.

Firstly, for a rare, potentially fatal heart condition, pulmonary arterial heart condition, a new medicine will be available, Uptravi.

And Uptravi will help 700 patients a year save up to $41,000 a year. Instead of $41,000, it will be available for as little as $6.60 a script.

This could save lives, extend lives, improve lives, improve quality of life and improve peace of mind. And to have a new medicine for a potentially fatal heart condition is just such a powerful thing, for 700 families around Australia, their lives will be different and this is just an immensely important step forward.

In addition, at the same time, we’ll also be listing Vyvanse for adults over 18 who are diagnosed with ADHD.

Now, ADHD is something which people can manage, but it can also be deeply debilitating.

And for potentially thousands of over-18s who for the first time will have PBS access to this medicine, it can mean that they will be able to be calmer, more patient, it can give them greater peace of mind, greater employment prospects if the ADHD has been sufficiently powerful as to impact their ability to conduct their work.

And if it improves their employment prospects it can improve their family and economic circumstances, and also their mental health, because anxiety and depression can be associated with ADHD. So these are incredibly important things.

At the same time as continuing the day-to-day work of the PBS, our pharmacists have been part of the global battle and the Australian battle against COVID-19. On that front, what we’ve seen is very pleasing results in Australia: 13 consecutive days without cases, 13 consecutive days with zero community transmission.

The state figures will come through as the morning progresses and be updated, but we have the potential, on early advice, for a fourteenth consecutive day of zero cases.

And we have, at this point in time, zero lives lost in that period of time. We now have zero cases of community transmission and we have zero people in ICU around Australia.

Very importantly, we’ve seen the number in hospital drop, which is a leading indicator of potential serious illness.

That’s dropped from 34 Australians less than two weeks ago to 14 Australians in hospital today with COVID-19. So, very significant.

In the last 24 hours we’ve seen over 600,000 cases worldwide, 102 million cumulatively. Agonisingly, we’ve seen 2.2 million lives lost and over 16,000 lives lost in the last 24 hours on the latest figures that we have.

So against that background, the one good piece of news is that the world has seen the average daily rolling seven-day case numbers drop from 700,000 on January 10 to 550,000 at the moment.

So that’s the first significant signs of drop in global cases. There’s a lot more to go and there’ll be ups and there’ll be downs. But this is a sustained drop in global cases around the world, not just in one jurisdiction but in a number of jurisdictions.

So, all of that’s positive. But the next great thing is for the world to advance and progressively complete the rollout of the COVID-19 vaccines, and today I am delighted that our pharmacies will be joining the rollout of COVID-19 vaccines for Australia.

We will be issuing what’s called an expression of interest to all of our 5,800 community pharmacies tomorrow.

We will be inviting them, subject to meeting standards, to participate in the rollout, just as they do with flu.

They are experienced, they are trained in dispensing medicines, and they would be participating from Phase 2A onwards, and that means more points of presence for Australians in terms of where they can receive their COVID-19 vaccine.

I want to thank all of our pharmacists for participating in the rollout. It will be up to them, it is voluntary whether they seek to participate.

They will be encouraged and if they meet these standards, they will be included, which will give more options and better access to Australians. I’d be delighted to take any questions. I think, Alex, starting with you.


Just on the hypertension medication, is that a life-saving medication?


This is potentially a life-saving medication. It will mean different things to different people, depending on their circumstances. Medicines can work with differing degrees of effectiveness, but all up, this can improve lives, extend lives, or save lives.


And what does it mean for you to be able to make these announcements that will really be life-changing for people?


This is just a great privilege. It’s one of our passions to make sure that we keep the PBS flowing, that we list every medicine which the experts recommend and which the PBAC approves. It will continue to be an article of faith and belief and commitment from this government.


And in terms of the medication for ADHD, has there previously been more of a focus on childhood medications? Is this kind of a new phase, going forward?


Yes, until now the focus with ADHD has been on under-18s. This expands the focus to adults.

There are many adults with ADHD, thousands and thousands of adults in Australia, and it can be something that they can manage well, but this will add a really powerful medicine to assist them with their management, to give them potentially greater patience, comfort, the ability to complete their tasks, whether that is at home, in the family, at work or in the community.


And are you confident that many pharmacies will take up this vaccine rollout?


I’ll let George speak to that, but we hope as many pharmacies as possible take up the rollout.

And is this rollout coming sooner than expected?


We’re on track for our rollout commencing in late February and completing in October, that remains our guidance, and we’ve done a lot of work to reaffirm that this week.

We’re always subject to shipping and international events and TGA approvals, but the latest advice is that the AstraZeneca assessment will be completed on time and on track by the Therapeutic Goods Administration, and subject to that we hope to be able to commence the AstraZeneca in early March and the Pfizer in late February. Happy to take a question from Melissa.


Thank you Minister. Just two questions. Firstly, can you give us an update on the status of the New Zealand travel bubble suspension, is that going to be continued, or will that suspension now lapse?

And can you also give us an update on the security of vaccine supplies from Europe given the ongoing developments we’re seeing each day there?


So, two questions from Melissa, one in relation to New Zealand, the second in relation to vaccine supplies from the EU.

So, firstly, in relation to New Zealand, the acting Chief Medical Officer, Professor Michael Kidd, is meeting with New Zealand authorities this morning for the latest.

We’ve had very good news out of New Zealand over recent days. There’s been no community transmission beyond those first three cases, all of which were most likely affected within the hotel quarantine system.

He’ll have more detail for final advice to the Australian Government, and that will be announced this afternoon.

I don’t have it yet because that process isn’t completed yet, but we’ll provide guidance and update this afternoon.

With regards to the EU, in the last 24 hours we have spoken with the EU, Pfizer and AstraZeneca, as a government.

I’ve spoken directly with the Australian country heads of Pfizer and the EU (correction AstraZeneca).

We have our diplomats that are working with the World Health Organization and the European Union through the commission.

And the advice that we have from all three sources at this stage is that our vaccine supply and guidance remains on track.

Our advice is that our vaccine supply and guidance remains on track, those dates that we provided earlier on in the week, followed discussions with country heads of Pfizer and AstraZeneca, took into account supply and regulatory conditions within Europe and have been reaffirmed in the last 24 hours.

The guidance from the EU is provisional and preliminary at this stage, so I will remain cautious, but that guidance is that the EU regulatory steps are not aimed at Australia, and are not expected to effect Australia.

But we’ll continue to engage with the EU on a daily basis and at this point in time, we are in the very fortunate position of having guidance that our international supplies, Pfizer commencing with approximately 80,000 doses per week in late February, AstraZeneca with approximately 1.2 million doses for March, commencing in early March, and then very importantly, bringing forward ahead of schedule the CSL doses, at approximately 1 million per week, commencing in late March, which would deliver 2 million doses of the AstraZeneca CSL-produced vaccine here in Australia.

And I think the fact that there will be 50 million doses produced in Australia, with their latest advice reaffirmed by the company yesterday, that CSL is ahead of schedule, is very important comfort and news for Australians.

There’ll be lots of ups and downs around the world. Global supply challenges, there’ll be issues over the coming months, inevitably.

But we have developed a strategy for all circumstances and I think that’s extremely important comfort for Australians.

We’ll just keep going and our goal is very clear and our advice is very clear that we aim to have the country vaccinated before the end of October. Mark.


Thanks Minister. Minister, two questions. First one: How many Australians do you think will get vaccinated through the pharmacy program and who will initially be eligible?

My second question goes to the story that’s floating around today about GPs considering charging for dressings and Band-Aids. Would you be concerned that it could deter people from actually going to their GP?


So, just on the second story with regards to a proposal to government, not of government.

It’s one of numerous proposals from a particular task force. We won’t be putting in place extra charges for patients. I am ruling that out.

I just want to be categorical on that. That’s not a government proposal, it’s one of numerous proposals put forward to us, it’s not one that we’ll be accepting.

We will be working with general practices and doctors on alternative sources of government support for them, not patient contributions. That’s ruled out.

Secondly, in terms of the number of pharmacies, George will be better placed than me to estimate it, but we’ll put that forward.

I will take a break for a moment and invite George and then John Paul and then we’ll come back to Claire and David to finish. George?


Good morning. It’s very important to utilise the network of 5,800 community pharmacies to increase the uptake of the COVID-19 vaccination.

That’s really, really key in this country, and for us to vaccinate the whole community before October, it just makes sense that community pharmacy and the workforce in community pharmacy, like John Paul, can be one of the options that families and members in local communities can have. To come and get their vaccine in the same place where they feel comfortable to get their prescriptions dispensed in a timely manner, other over-the-counter medicines that they use on a day-to-day basis.

It’s a safe environment, they’re very comfortable visiting their local community pharmacy, and they’ve often utilised pharmacies to get vaccines against flu in the last few years.

And we look forward to actually vaccinating against all diseases eventually.

Pharmacists have got that scope of practice and we are trained to vaccinate against all the diseases.

The most important thing about vaccinations is to get the vaccination rate as high as possible.

So giving the public an option to come in their local community pharmacy just makes sense.

So I’ll hand over to John-Paul, the local community pharmacist. John Paul, come through.


Thanks George, thanks Minister. I’m John Paul, I’m the proprietor here along with some business partners at Mount Martha here.

Our team, along with pharmacies all over Australia are ready, willing and able to begin vaccinating our communities.

We’ve done so well, Australians have done so well at wearing masks and helping to protect our neighbours and each other from COVID and this is the next stage in protecting our communities.

So the only thing I really need to add is just: come on, Australia, let’s just get vaccinated. The time’s perfect. Let’s just do it.


You’re confident that many others will get on board as well?


I think nearly every pharmacy will want to be involved in this because we love our patients, we love our communities, we’re there for them and it’s a no-brainer, it really helps protect us all.


And are you confident you’ll see people literally knocking on the door?


If it was anything like the 2020 flu vaccine, it’s going to go crazy.

There will be people who will want to put their name down tomorrow to get vaccinated as soon as the vaccines are available.

So I’m very confident and I think it’s a very sensible and forward-thinking idea that our government has thought of, and we are ready to start.


And John Paul, can I just ask you as well on the PBS listings, what’s your reaction just as a pharmacist to hearing that now more people can access these medications?


Specifically on the Vyvanse, I think that’s an excellent decision.

We do help a lot of adults at the moment and this will provide them with an opportunity to lower the cost of their medication.

They need it to focus, to attend work and to perform well at work. So I think this is a very sensible decision, along with the heart medication as well.


There we go. How good is John-Paul? Thanks for your patience. To Claire, and then to David. Claire?


Thanks Minister. Just a couple of questions following on from what you were saying about the EU advice being provisional, that it’s not aimed at Australia. Given that’s the case, why couldn’t we be put on the exemption list that the EU has created for countries which specifically will not be impacted by the export controls?

And secondly, at the end of last week, Pfizer at a Senate committee hearing mentioned that they were looking at ramping up their supply capacity, their manufacturing capacity, and there would potentially be more doses available. Is that something that Australia is seriously considering being able to buy? How would we go about doing that?


Sure. So firstly, with regards to the EU, that’s a matter for them in terms of their regulatory processes. We’ve seen that that’s evolving and unfolding rapidly.

But the guidance we have remains that from both Pfizer and AstraZeneca that they are not seeing, at this point, any impact on the supplies and shipping which has been outlined.

Late February commencement for Pfizer and then, subject to TGA approval, early March commencement for the AstraZeneca international and, again subject to TGA approval, late March commencement for the first million and then the second million of the 50 million doses of CSL, well ahead of schedule.

So it’s a matter for the EU. But the guidance we have, not only from the companies but from the EU, is that our schedules remain on-track. I think that’s very important for Australians.

And ultimately underpinned by what I think is one of the two most important decisions Australia has made: the China borders a year from tomorrow, and the on-shore production of 50 million CSL AstraZeneca units in Australia. Now, there was one other question, I apologise, Claire?


Yes, on Pfizer, whether Australia is in a position to bid for more doses if they do ramp up production.


So, we’ll continue to follow the advice of the vaccines panel led by Professor Brendan Murphy. Where they recommend more, then we will acquire more.

So, we are in a strong position because we have 140 million doses. If more is recommended then more will be purchased.

And so, we’re reliant on the medical advice. It’s very much the case that vaccines should only be purchased on the basis of the strongest possible medical advice.

That’s always been the case in Australia and will continue to be the case, and then only used in accordance with the advice of the medical regulator, the TGA, and the Australian Technical Advisory Group on Immunisation.

So we’ll continue to follow that advice. If they recommend more then we’ll be in a position to purchase more.

And then, David, who’s been very patient, I apologise.


Okay. Question from David Crowe here at The Age and the Sydney Morning Herald. On the vaccine rollout with GPs and with pharmacies, there’s obviously going to be a huge demand. GPs are already quite busy with their workloads now, as are pharmacies. There’ll be requests for out-of-hours vaccines also for Sundays as well, as a possibility to vaccinate people on those days in order to meet demand. Now, that may increase the cost because you’ll have to pay a higher rate for those staff.

So can I just ask on that front, are you open to a higher cost for this GP and pharmacy program in order to open on Sundays, to make sure it’s as accessible as possible? And just on the very big commitment, it’s free for everybody, isn’t it?


Correct. So, firstly, the vaccines are universally available, they’re voluntary and they’re free.

So the government is providing and meeting the costs of all of the vaccines.

As part of that, we’re building the number of points of presence and where after-hours support is required in relation to the various contracts, then that’s provisioned for.

So we’re aware of that, that’s appropriate, and what we’re doing is making sure that there’s appropriate remuneration, which is being agreed with the Pharmacy Guild, the AMA and the Royal Australian College of General Practice.

And significantly I am able to increase our guidance on the likely number of points of presence for vaccination in Australia.

We had been conservative in estimating 1,000 points of presence.

I am today able to indicate that it is going to be at least 2,000 points of presence around Australia.

We’ve had much greater uptake from the general practice community than we had initially anticipated. That’s a credit to them.

And we’ll again be conservative in our estimates of the pharmacy community, but if you hear John-Paul and you hear George, there’s no Ringo, but if you hear them, you can see the enthusiasm from within the pharmacy community.

So, Australia’s health professionals are stepping up and I want to thank them and honour them and say our goal and our commitment is very clear: to keep Australians safe. Thank you very much.

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