Radio interview with Minister Butler and Matthew Pantelis, FIVEAA Mornings - 2 October 2024

MATTHEW PANTELIS, HOST: Federal Health Minister Mark Butler on the line. Minister, good morning.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, Matthew. How are you?
 
PANTELIS: Alright, thank you. Have you considered making it free for all?
 
BUTLER: The way these vaccines and medicines are listed on the PBS or what's called the National Immunisation Program, which gives vaccines to people for free, is that a company has a particular product, in this case a multinational company GSK, they have this pretty terrific new shingles vaccine that's just come onto the market. It's much more effective than the old one, and it's much more longer lasting it lasts for at least ten years. They then go to a committee of medicine's experts that's been in existence for decades here in Australia, it's called the Pharmaceutical Benefits Advisory Committee. They present a case that says, look, this new medicine that might help beat cancer or a new vaccine for flu or COVID or shingles, it's clinically effective, it does what you want it to do from a medical point of view, but it's also cost effective and the taxpayer should support it for particular population groups.
 
Under the federal legislation that has been in place for many, many years, the National Health Act, I, as a minister, can only list a vaccine or a medicine on the PBS or the National Immunisation Program if it's been recommended by this group of medicines experts. That means taxpayers are getting value for money. We spend a lot of money on medicines and vaccines and this means that although there's always a bit of an argument for every medicine that comes onto the market or every vaccine that comes onto the market to be available to everyone. We do want medicines experts going through and determining whether or not it's going to be effective.
 
Now, the company that has brought this new vaccine onto the market, called Shingrix, has never suggested it should be available to under 50s. At the moment, what we have, as you said in your intro, Matthew, we have it available to over 65s and to younger adults who have compromised immunity. The reason for that second group is if you have compromised immunity because you have a condition that compromises your immune system, or you're on a medicine that compromises your immune system, you're about twice as likely to get shingles in the first place and if you get it, you're going to be hit much harder than a healthy young adults who have fully performing immunity.
 
We’ve had this program since November. It is the most comprehensive shingles vaccine anywhere in the world, with maybe the exception of Germany. They've got a pretty comprehensive one as well. And in just those ten months or so, about 1.5 million adults, mainly over the age of 65, have availed themselves of the free vaccine and they've saved more than $800 million in out-of-pocket costs. This is a huge achievement I'm really proud of.

But at the moment, there is no proposal for the shingles vaccine to be subsidised for younger otherwise healthy adults. Now, I know getting shingles is really awful, I had it as a younger adult. It's quite rare to get it under the age of 50 if you're healthy and you have a fully functioning immune system. But I did, and it was pretty awful for a few days there. But there is no proposal right now for the vaccine program in the sense that taxpayers would pay for you to get a vaccine to be extended to younger, otherwise healthy adults.
 
PANTELIS: All right. So not even on the drawing board in the distance, in the on the horizon?
 
BUTLER: This is a new vaccine, and what we see with medicines and with vaccines is that they might come onto the Pharmaceutical Benefits Scheme or the PBS for a particular population group and then over time, as we learn more about how that medicine or that vaccine operates we expand it. When I first listed this new shingles vaccine, it was for over 70-year-olds. Then a whole lot of new clinical trial data came out that showed we should lower that age to 65, which I did. When that advice came through, I did that immediately. And then there was a further change that I announced only a few weeks ago here in Adelaide for a bit over 200,000 younger adults who have a range of conditions that compromises their immune system. They might have kidney disease or a range of other things. As soon as new evidence emerges that it would be effective for a new group, that evidence goes before this group of medicines experts and they'll provide advice to me.
 
They are dealing with a huge amount of work right now, as you'd imagine, Matthew. We are lucky enough to be living in this turbocharged period of discovery where new medicines are coming onto the market to treat sometimes even cure conditions that we thought ten years ago were untreatable or incurable. But the number of new medicines coming on the market for cancer, for example, is just extraordinary. Changing lives, saving lives that we just didn't think a few years ago could be saved. They're doing an amazing job this group of experts and in the time I've been the Health Minister a bit over two years, we've made more than 250 new listings of new medicines. cutting edge medicines. I announced one this week that if it weren't listed on the PBS, would cost $190,000 per patient.
 
PANTELIS: Oh, goodness. Wow.
 
BUTLER: They'd have to pay out of their own pocket. It's a great medicines and vaccine scheme we have.
 
PANTELIS: Yeah.
 
BUTLER: But the reason why it's great and it's sustainable for taxpayers is it's not determined by politicians. Although our job is to act on the advice of medicines experts.
 
PANTELIS: Yeah.
 
BUTLER: Experts look very carefully at the evidence to make sure that taxpayers are getting full value for money.
 
PANTELIS: All right. And thank goodness this is one thing that our tax dollars should be used for is buying medicines like that for people in need, the expensive medicines that most of us wouldn't be able to afford, and making it a reality and saving lives with it. That's exactly what our tax dollars should be used for. And that's a good thing the PBS scheme that's been around for quite some years.
 
One last question. Jodie Oddy made the point yesterday the government vaccine, the one you're funding and there's a number of them only has an efficiency rating of around 60 odd per cent. So why don't we get behind one that covers more people that strikes better, that keeps us safer, 90 odd per cent strike rate against shingles?
 
BUTLER: It's a new one the Shingrix vaccine. It as I said, it's only been on the programme since the 1st of November. I can't remember exactly the efficacy rate, but it is in that order. I thought it was 60 something per cent.
 
PANTELIS: Yeah, 60 something.
 
BUTLER: That's much more effective than the old vaccine. It is much more effective and it lasts much longer. Now, unfortunately, sometimes we do have, there are some vaccines that are 100 per cent effective, like measles, for example, encourage parents to get their little ones vaccinated for measles. Unfortunately, we're dropping below the herd immunity rate for measles vaccines in parts of Australia. That's a very serious thing that I'm concerned about. We're seeing this in other countries around the world as well. Sometimes there is a vaccine that if you take it, polio, measles, those sorts of things, they're 100 per cent effective.
 
PANTELIS: Yeah.
 
BUTLER: Often though we see this with flu vaccines but also with the shingles vaccine, they're not 100 per cent effective, but they are very effective.

PANTELIS: Yeah.
 
BUTLER: This is a much better vaccine than the one it replaced. The pace of discovery by our brilliant scientists and scientists around the world in medicine right now is utterly breathtaking. I have no doubt that this vaccine, over time, will be replaced with one that's even more effective and even more long lasting. But at the moment, this is the best one in the world. And we have the most comprehensive vaccine programme for shingles in the world.
 
PANTELIS: Yeah, alright. The stocks of it, do we have enough? Because that was an issue where people got the first dose and then couldn't get back to get the second. There was just none in supply. Have we resolved that now?
 
BUTLER: Yeah, it was an issue. Along with the states we do economic modelling about how many people we think will take up a new vaccine or a new medicine. We use the usual model when I put the new shingles vaccine on the programme in November, and frankly, we underestimated it. There was such demand for it, was about 40 per cent over what we thought it would be that we did start to run short of supply. I had to go to the company globally and purchase another 750,000 doses in, quick time. The company was good enough to make sure we got them quickly. They've supported what we've done here really well.The last time I looked, which was probably sort of ten days or so ago, we had about 500,000 doses in the country. Some of them are in warehouses, some of them are in the vaccine fridges of your local GP or your local pharmacy. But I'm very confident, even though we did announce a modest expansion about another 200,000 Australians a couple of weeks ago. I was careful to make sure that we had enough supply in place to accommodate the older Australians who still haven't had it.
 
I encourage you to go out and get it, it's free of charge, it would have costed it would have cost $560 before the 1st of November. For you now it is free of charge, so go out and avail yourself of it. as your caller Dave was saying it can have, it's not just uncomfortable and painful for a few days.
 
For older Australians, for people with compromised immunity there can get into your eye and have really serious consequences for your vision, including the possibility of going blind in one eye. And a range of other things that will lead you to be in hospital. It's no small thing, particularly for older Australians.
 
PANTELIS: Absolutely.
 
BUTLER: It's out there free of charge. Go and get it.
 
PANTELIS: Good on you, Mark Butler. Thanks for your time.
 
BUTLER: Thanks, Matthew.
 
PANTELIS: Federal Health Minister on shingles.