Minister for Health and Aged Care – press conference, 2 January 2025

MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks for coming along on this beautiful morning in Adelaide, in the new year. I've got a couple of announcements today. First of all, around cheaper medicines more broadly, and then a very exciting announcement about the extension of PBS listing for a highly effective cancer treatment drug Lynparza, which we're joined by Ben, who is the Country President for AstraZeneca, the sponsor company for this drug, Brigitte, who's very generously flown in from Wollongong to talk about her experience, and Nick, who's a local medical oncologist at the Royal Adelaide and other places here in South Australia, treating breast cancer, among other cancer types as well.
 
First, I wanted to address our general commitment as a government to cheaper medicines. We knew when we came to government, that household budgets were under extraordinary pressure through the global cost of living shock that followed COVID, the supply shocks that were involved with COVID, and also the invasion of Ukraine by Russia. We know that the affordability of medicines is a critical issue for households, the ABS – the Bureau of Statistics – had told us that as many as a million Australians were going without medicines that their doctor had said was important for their health, because of affordability concerns. And that's why we have put in place a range of different chapters of our cheaper medicines policy. In July 2022 we slashed the maximum amount that pensioners and concession card holders would pay for all of their medicines needs over a given year, by fully 25%. And already, in a couple of years, that's delivered 66 million additional free scripts for pensioners going to the chemists, able to get their script filled without having to pay anything at all. Then the following year, we delivered the biggest cut to the price of medicines in the 75-year history of the PBS, slashing the copayment for general patients from $42.50 for a script to $30 and then our third leg was to deliver 60-day scripts for about 300 common medicines for people with chronic conditions, often on medicines, not just for months or even years but sometimes for the rest of their lives, delivering them much more convenience, but also significant savings.
 
Yesterday, the fourth leg of our cheaper medicines policy took effect, and that is in the form of a freeze to the maximum copayment for PBS medicines, a freeze of one year for general patients through the course of this year, and a freeze of up to five years for pensioners and concession card holders. That means that in addition to the cut we made - the 25% cut to the Safety Net Threshold for pensioners back in 2022 - their maximum copayments will not increase until the end of this decade. We know that households are still really doing it tough with this cost-of-living crisis that has been sweeping the world, but we know that cutting health costs in particular, is not just good for the hip pocket, it's importantly, really good for people's health as well. We'll continue to do everything we responsibly can, not just to improve health policy in this country, but to improve the affordability.
 
In addition to our general approach to making medicines cheaper, in the last couple of years we've listed or expanded the listing of more than 280 new medicines giving Australian patients affordable access to some of the best, cutting edge treatments available anywhere on the planet. And today, I'm really excited to announce the extension of Lynparza, a drug that's already on the PBS for certain patients with breast cancer, with prostate cancer and ovarian cancer.
 
We know that breast cancer is the most common cancer afflicting Australian women. Extraordinarily, around one in seven Australian women will experience breast cancer at some point in their life, with almost 60 new diagnoses every single day, on average. We have some of the best survival rates for breast cancer on the planet. But still, tragically, more than 3,000 Australian women lose their lives to breast cancer every single year. Often, breast cancer is associated with a genetic mutation, particularly to the BRCA genes, and that mutation is often inherited. The mutation becomes particularly risky if the breast cancer has become metastatic, that is: it's spread to other parts of the body, like the brain, the liver, the lungs, or the bones, for example.
 
And today, I'm really excited that Lynparza, which is already on the PBS for different cancer types, will be available at PBS prices for breast cancer patients whose cancer has become metastatic and also have an inherited mutation to the BRCA genes. We think this will bring affordable access to around 300 patients every single year with this type of breast cancer, who otherwise would have had to pay $72,000 per course of treatment for this lifesaving, cutting edge treatment now available to them.
 
I'm also really excited to announce that we'll be extending Medicare payments for the actual genetic test that will tell you whether or not you have an inherited mutation to the BRCA1 or the BRCA2 gene. Currently, that Medicare payment has been quite restricted. We're now making it available to every single breast cancer patient, so soon after your diagnosis, you will be able to get this genetic test, determine whether or not you have an inherited genetic mutation or mutation of the BRCA genes in particular, and you won't have to pay as much as $1,200 which is what this test would cost without the Medicare payment. So this is just part of our ongoing commitments to the affordability of medicines, but particularly to ensure that Australia's patients have access to the best, cutting edge treatments available anywhere in the world, at affordable PBS prices. I'll now hand over to Nick to say a bit more about the effectiveness of this drug.
 
MEDICAL ONCOLOGIST, ASSOCIATE PROFESSOR NICK MURRAY: Thank you, Minister. It's very exciting to be here today. I think it's really quite marvellous how much progress we've made in the treatment of metastatic secondary breast cancer. In the last 10 or 15 years, survival rates have just escalated dramatically. Women and men are living longer and longer with breast cancer. When I started training, we talked to people about having a life expectancy of maybe one and a half to two years. Now we're talking about five, six, seven years or more. It's quite remarkable. And what I find equally remarkable is the fact that now, with the addition of Lynparza to the PBS, we're able to prescribe all the drugs that we know about that make those differences. Over the last two or three years in Australia, through the PBS, we've been given more and more access. And there is not a drug out there now that you could point to and say, “well, that's not available to the Australians who need it with breast cancer”. So a very exciting day.
 
JOURNALIST: So with Lynparza, what do you think stands out with this?
 
MURRAY: One of the most remarkable things to me is that someone sat down and worked out a new way of tackling specifically genetic breast cancer, designed a drug and took it all the way through to actually delivering it as a treatment for ovarian, prostate and breast cancer. It improves survival, particularly for women who go on to it early in the course of their illness. Those are the main things.
 
JOURNALIST: How does exactly does it work? Can you talk through the process and what is exactly targeted?
 
MURRAY: So the way it works is: we know that the BRCA gene makes a protein which is very important for stopping mistakes being made when cells copy their DNA. If you make mistakes, you get mutations. Mutations are what lead to cancer. And the real beauty of the design of Lynparza is that someone looked at that and said, “okay, so when you have a mutation, you're making more mistakes. If we can find a way to make even more mistakes happen, then that will be a way of treating specifically those women with that cancer”. And that's how these drugs work.
 
METASTATIC BREAST CANCER PATIENT, BRIGITTE PHILLIPS: I'm Brigitte, a metastatic breast cancer patient. I hate saying those words, but it's true. And so I just wanted to share a little bit of my story today. I hope you don't mind if I'm referring to my notes. So it was three years ago. It was right in the middle of one of those COVID pandemics. I was seven months pregnant. And I felt just a hard patch in my right breast, and I just assumed it was about a weird pregnancy thing. But my mum convinced me to see a doctor. And so I did. I saw a doctor straight away, and she did all of the right things. She was amazing. But no one thinks that you're going to get cancer at 31, and so I was diagnosed with mastitis. And it took a month of cycling through different antibiotics, lots of hospital visits, until I eventually got the correct diagnosis.
 
And so I was eight months pregnant when I was told I had breast cancer. I was told I had a 8.8 centimetre tumour in my right breast and that it had already spread to the lymph nodes under my arms. I was told - I was told I would need more tests to know if it had spread anywhere else in my body. And that was something I really didn't want to think about at the time. So after that, things happened really quickly. I had my beautiful daughter via C-section early. And the day after I got home from the hospital, I was called back to my oncologist office and told that the cancer had already spread within my spine, and it was in my femurs. And I was told that it was incurable and that my treatment would be palliative.
 
No one talks about what it's like in that moment. It's basically - time stops. In an instant, I went from being a very normal 31 year old, to be someone who was dying. It was hard to take. What's more, I don't have a family history of cancer, and so it was never something that was on my radar. But despite not having a family history of cancer, because I was so young and my cancer was very aggressive, my oncologist recommended that I undergo genetic testing to see if I had a mutation in one of the BRCA genes. And at the time, I knew that there was a new treatment available that targeted those genetic mutations. So I know it seems odd, but I was really hoping that I did carry that genetic mutation. Because the thought that there was a treatment available that was more targeted, a treatment that basically could be made, tailored to me, personalised for me, that filled me with a lot of hope. And so I remember it takes about four weeks to get the results of those tests. I remember for those four weeks, really hoping that that result would come back positive.
 
And so when I was told that I do carry a BRCA1 mutation, it was shocking, but it was also a huge relief. The relief was short lived. Basically within the same breath of being told I had a BRCA1 mutation. I was told that the treatment that was going to work best for me was not listed on the PBS. A lot of people don't have good context for how expensive these drugs are. I was told that it could be tens of thousands of dollars a year to access this treatment. So I'm incredibly grateful for some very generous friends and family, and also to the Illawarra Foundation, and also the pharmaceutical company who made it possible for me to actually be able to afford the medication. Because I honestly believe it changed the course of my treatment.
 
So it's now been three years, over three years, since I was diagnosed. And if you'd told me that three years ago, it would have seemed almost impossible that I would be alive, today. I got to see my beautiful little girl celebrate her third birthday back in August, I get to see my five-year-old start school next year. So they're all milestones that I don't take for granted. Cancer is still a really big part of my life, and maybe it always will be, but this treatment means that I just take my pills every day and get on with being a relatively normal mum, a wife, a sister, a daughter. And so it really does mean a lot to me that this treatment has been listed on the PBS. It has been a long time coming, but it will make a massive difference to a lot of Australians out there, happy to answer any questions.
 
JOURNALIST: What would the alternative have been instead of taking these pills?
 
PHILLIPS: So at the time I was on my first line of chemotherapy. It wasn't working. And so we knew we had to make a change. The next line would have been - you can correct me if I'm wrong - would have been more chemotherapy. And those drugs, they are amazing in their own right, but they're not targeted. They have a huge side effect profile. And so living on chemotherapy is very different to living on targeted therapy.
 
JOURNALIST: And how does it make you feel when new drugs come on to the market? You said you've got a daughter –
 
PHILLIPS: It gives me so much hope! And I don't know - I mean, thankfully, she will have the knowledge to know, when she's 18, she'll have the choice to get tested. And they'll have the choice to find out if they do carry a BRCA mutation, and that will be their choice. But the thought that there are new medications coming on board, the thought that so much has changed in the last - even the last three years - so much has changed. And having these new medications listed. When you've got metastatic breast cancer, you're told you'll be on treatment for life. And so even when you're not on those treatments, knowing that there are - you're adding to that list of treatments that are possible. It gives you a lot of hope.
 
JOURNALIST: So are you essentially just on going to be on this treatment, now.
 
PHILLIPS: I will be on this treatment for as long as it keeps working.
 
JOURNALIST: Is that in conjunction with other treatments?
 
PHILLIPS: Nope, just four pills a day.
 
JOURNALIST: If you don't mind me asking, is it still classified as palliative?
 
MURRAY: (INAUDIBLE) The aim is to control the cancer and for you to live as long as is possible.
 
PHILLIPS: I think that’s everyone’s aim.
 
JOURNALIST: Just a little bit about yourself. Do you work?
 
PHILLIPS: I work part time. And so because of this treatment, I have been able to go back to work. I was diagnosed a week before I started maternity leave, which was somewhat convenient. And then when I was due to go back to work, I decided I'd start that maternity leave again. So I took another year to really enjoy it. I have gone back to work. About a year ago, I worked part time for the University of Wollongong.
 
ASTRAZENECA, COUNTRY PRESIDENT, BEN MCDONALD: Hi, I'm Ben McDonald. I'm the Country President of AstraZeneca in Australia and in New Zealand. I would like to thank Minister Butler and the Australian Government for this new listing for Lynparza on the PBS. With this listing, hundreds of Australian patients with metastatic breast cancer may now have access to Lynparza on the PBS. I'd also like to thank Associate Professor Nick Murray, and also Brigitte Phillips, who is living with metastatic breast cancer, and who's joined us here today. Thank you. Hundreds of Australian patients may now be able to access Lynparza on the PBS when they have a HER2-negative but BRCA-mutated, metastatic form of breast cancer. This listing means that patients are able to access Lynparza. It's a targeted oral therapy that means that hundreds of Australian patients may now get the benefit of Lynparza for their metastatic breast cancer disease. These patients are often younger, and they're balancing family responsibilities with their work commitments as well as dealing with the psychological and physical hardships of their diagnosis. So AstraZeneca is very proud of this new PBS listing for Lynparza, and will continue to work with the Australian Government for earlier, faster and fairer access to diagnosis and to medicines. Thank you.
 
JOURNALIST: How many patients do we think will be using it?
 
MCDONALD: We think hundreds of Australian patients each year with this listing will now have access to this medicine for their metastatic breast cancer. The Minister mentioned up to 300 patients per year.
 
JOURNALIST: And has this medicine been used quite frequently in other countries? And what sort of results?
 
MCDONALD: Yeah, so this medicine has been on the PBS for a number of years in other settings, ovarian cancer in particular. But it's also approved in many countries around the world with great success.
 
JOURNALIST: Start things off with bulk billing. Are you considering lifting the bulk billing incentive paid to GPs?
 
BUTLER: The year before last, we tripled the bulk billing incentive, the largest investment in bulk billing in the history of Medicare, because we had heard a very clear message from GPs through their College: bulk billing was in “free fall” and general practice was at a tipping point. That was no accident. It was a result of 10 years of cuts and neglect, and in particular, the freezing of the Medicare rebate that was kicked off by Peter Dutton when he was the Health Minister a little more than 10 years ago. We we've seen that investment, that record investment in bulk billing, has already caused that free fall to stop, and indeed for bulk billing rates to start to climb again in every single state and territory across the federation. Now, of course, we'd like to do more in bulk billing. We've been committed to Medicare since we introduced it over 40 years ago. We're focused on getting more doctors into the system, we're focused on more bulk billing, and we're focused on more options for urgent care. We've delivered a whole range of things that are making a really meaningful difference to general practice and to the options, the affordable options for patients. But we know there's more to do.
 
JOURNALIST: Does that mean we can expect more in the future?
 
BUTLER: I don't have anything to announce today. But I've been very clear from the time I was appointed as Health Minister almost three years ago, that fixing the mess that we inherited in Medicare - it really was in the most parlous state that it had been in for 40 years, after 10 years of the former government. Fixing that mess would not take one term of Parliament. There's more we want to do to deliver more doctors, more bulk billing and more urgent care. Just as I've said today, there's more we want to do to make medicines even cheaper. I don't have any announcements today. But the Australian people can be very, very assured that a Labor Government will always do what it can to strengthen Medicare.
 
JOURNALIST: Do you think there's benefit in moving towards paying GPs and paying them an annual lump sum, rather than fees for appointments?
 
BUTLER: I don't think there will ever be a situation where there is not a fee-for-service element to Medicare. Medicare is very much a system that pays doctors and other health professionals - but particularly doctors - a fee for a particular service that they deliver. And there's been a long argument that we should blend that with more general payments or bundled payments to GPs. Because what they do now is not deliver single episodes of service, but they are more and more involved in delivering wraparound care for people with complex chronic conditions. And I've said for a couple of years now, through our MyMedicare system, that is a pathway we want to travel down. And I think we have the support of the AMA and the College of GPs to do that. But we're going to do it in a steady way. We're going to do it in a way that brings not just the medical community with us, but also patients - that they recognise there's a value proposition for them. But I don't think we'll ever see a situation where there's only annual payments and no fee-for-service, but I think we will see an increasingly blended future.
 
JOURNALIST: Will an overhaul of the health system be announced in the lead up to the election?
 
BUTLER: I've been very clear that as long as we have the privilege of governing this country, there is more that we want to do to strengthen Medicare. What we've already done has made a meaningful difference. It's delivered more doctors: the biggest increase to doctor numbers in over a decade. It's delivered more bulk billing: last year alone, more than 5 million additional free visits to the doctor. And already a million patients have gone through our network of Urgent Care Clinics. That is making a meaningful difference. But it's still really tough to access affordable healthcare in Australia, after that decade of cuts and neglect. And there's more to do. So, of course, there's more we want to do.
 
JOURNALIST: Have you done any evaluation of the efficiency of Urgent Care Clinics?
 
BUTLER: They're still very new. Some of them have only opened in the last week, frankly. This is something that has funding attached to the program to ensure that it is evaluated. I said that when we introduce the program, against the opposition, frankly, of the Liberal and National parties. But already, this has been a great success. We've seen, as I said, a million patients or more go through these clinics. They're getting access to fully bulk billed expert urgent care, seven days a week, in a whole range of locations around the country. Not only is that good for the patients, but importantly also, we're starting to see the presentations to local emergency departments for those urgent but non-life-threatening emergencies, start to flatline or even decline as well. We're taking pressure off our busy hospital system, while we're also providing Australian patients with access to fully bulk billed urgent care in their community, when and where they need it.
 
JOURNALIST: Labor has been accused of running a Mediscare style campaign against Peter Dutton. Do you have any evidence that Medicare is under threat from the Coalition?
 
BUTLER: You just have to look at Peter Dutton's record as Health Minister, which, frankly, is pretty scary. He tried to abolish bulk billing altogether. He said there were “too many free Medicare services”, following on from his mentor, John Howard, who described bulk billing as “an absolute rort”. So we make no apology for pointing out the fact that the Liberal Party has been opposed to the idea of Medicare, as a universal health insurance system particularly that delivers bulk billed care, when it can, from the time we tried to introduce it more than 40 years ago.
 
Not only did Peter Dutton try to abolish bulk billing altogether, when he failed to do that, he introduced a Medicare rebate freeze that effectively froze the income of doctors for six years. So of course, that had an impact on bulk billing. He tried to introduce a fee for every Australian going to the local hospital emergency department. He tried to increase the price of scripts by up to $5. His record as a Health Minister is scary. And I make no apology for pointing out, as we lead into an election campaign, that on health care, on Medicare in particular, there is the clearest possible choice between a Labor Government that is committed to fixing the mess that we inherited from the former Morrison Government, and doing what we can to strengthen Medicare and make medicines cheaper, on the one hand, and a Liberal Party that is led by a man who doctors voted as the worst health minister in the history of Medicare.
 
JOURNALIST: Can you point to any current policy ideas that might put Medicare in under threat?
 
BUTLER: If you can point out any current policy idea that the Opposition has, other than their nuclear power plan, then you're a better analyst of politics than me. Because they have not released any costed, serious policies beyond nuclear power in more than two and a half years, pretending to be the alternative government of this country. What you can look at is the Liberal Party's record, and in particular Peter Dutton’s record as a former Health Minister, delivering 10 years ago the worst health budget in the history of the Medicare era.
 
JOURNALIST: We might just quickly go to Fiji, if that's okay -
 
JOURNALIST: One more fed pols question: Shadow Treasurer Angus Taylor has doubled down on his pledge that the Coalition will scrap laws requiring businesses to disclose their greenhouse gas emissions. What impact would that have?
 
BUTLER: More risk and more uncertainty for businesses and for investors. Let's just step back a second and remember where this came from. The Financial Stability Board was set up by the G20 in the wake of the Global Financial Crisis to manage risks to the stability of the global financial system. And several years ago now, it identified climate-related risk as one of the biggest risks to investors and to the global economy that we face in coming years. So that Board - chaired at the time by Mark Carney, a former Governor of the Bank of England and the Bank of Canada - that Board, endorsed by the G20, put in place a system of disclosure for businesses and investors to be very clear what their exposure to climate risk was and what their response to that risk was going to be. This is not a new concept. Management of risk is critically important for the economic prosperity of this country and for investor certainty. So why the alternative Treasurer of this country would want to introduce more uncertainty, at a time when we know that climate-related risks is one of the most significant risks to the global financial system is utterly beyond me.
 
JOURNALIST: So the Virgin Air flight crew that is being (inaudible) in Fiji. What support can the Australian Government send over to them?
 
BUTLER: Of course, the Australian Government would provide any possible support we could to anyone in trouble across the globe. But these reports from Fiji are only emerging right now. I'm advised that there are significant privacy considerations around it, and it's not appropriate to comment further on them at this point.
 
JOURNALIST: So are you aware of any support from Australian authorities being offered to the crew members of their families?
 
BUTLER: As I said, the advice I've been given this morning is that there are significant privacy issues associated with this, at least at this point in time, and so it's not appropriate for me to comment.
 
JOURNALIST: Is there any travel advice for other Australians?
 
BUTLER: Not that I'm aware of.
 
JOURNALIST: Just back to bulk billing. The Australian Institute of Health and Welfare, like you pointed out, says, you know, children and older Australians in particular have seen an uptick in bulk billing in 2024. But for 16 to 64 year olds, it says this has actually gone down slightly, from 70% in 2023 to 69% in 2024. What's your message to that age group of working Australians who are, you know, also struggling with cost of living, but probably paying more out of pocket than they were a year ago, or before these incentives came in. And is there anything more that the government can do to turn this trend around for non-concession patients specifically?
 
BUTLER: Of course, we want to look at all options of doing more to turn around the free fall in bulk billing that we inherited from the former government, for all Australian patients. Obviously, our first focus is for those with most significant financial need: pensioners, concession card holders and children under the age of 16, who have always been covered by the bulk billing incentive. But we've also been keeping a keen eye on bulk billing rates for non-concession card holders, the adults that you talked about, Natassia. And although there is a very marginal decline in bulk billing according to the AIHW data last year, frankly, those rates were in free fall before we tripled the bulk billing incentive. Tripling the bulk billing incentive, delivering the two biggest increases generally to the Medicare rebate in 30 years – more in two years than the former government managed in nine long years – has started to alleviate the financial pressure on general practice, finally. And that, I think, is having a knock-on impact on the behaviour of GPs in charging out-of-pocket payments to patients who are not covered by the bulk billing incentive, as well. But of course, as I've said time and time again now, of course we are looking at what more we can do to continue to provide more doctors into the system, deliver more bulk billing and deliver more deliver more urgent care options.
 
JOURNALIST: The average out of pocket for those patients is now about $47 and last year, I think 8.8% of people delayed seeing a GP because of cost. Do you think $47 is getting too high for people in these circumstances?
 
BUTLER: I just repeat what I've said: we're keeping a very keen eye on what's happening with patients who aren't covered by the bulk billing incentive, what's happening in areas of general practice where the incentive is not being taken up. I mean, some GPs are able to charge this incentive, but are not. And so I encourage GPs to avail themselves of this. It's there for good public policy reason. But of course, we're looking at what more we can do. We want to continue to strengthen Medicare after a decade of cuts. We know that bulk billing was in free fall. It frankly wasn't at the levels that the Morrison Government formerly trumpeted, and Peter Dutton continues to trumpet. And I saw again in your paper today, Natassia, those figures that the Liberal Party continues to boast about were described by the College of GPs as “misleading and skewed” because they included so many COVID-related items that had to be bulk billed in order to be charged. So what we've tried to do is provide much more transparency around bulk billing. It does reflect the claim that the College of GPs was making at the time we were elected, that bulk billing was in free fall. And that's why we invested so much in the 2023 Budget to turn that situation around. It's made a meaningful difference. But you're right to point out that there are cohorts who are still really doing it tough. We know there's more to do on bulk billing, and we're committed to doing more.
 
JOURNALIST: Just one final question, sorry, Minister. Who's going to absorb the cost of freezing to copayments for next five years, or so?
 
BUTLER: The government has made a Budget decision that that is the right thing to do. And that will save, we think, over the five years of the freeze, that will save households about $500 million. Now already our measures, in just two years or so, have saved consumers $1.1 billion that they would otherwise have had to pay out to pharmacists at the counter. So obviously, the freeze on that, is going to be a matter born by the Budget, but we think it's the right thing to do: not only good for the hip pocket of those patients, but good for their health. We don't want a situation where households or patients are choosing not to fill a script that their doctor has said is important for them, because of cost. Thanks everyone.