Radio interview with Minister Butler and Ray Hadley, 2GB The Ray Hadley Show - 28 April 2023

Read the transcript of Minister Butler's interview with Ray Hadley on cheaper medicines.

The Hon Mark Butler MP
Minister for Health and Aged Care

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RAY HADLEY, HOST: Mark Butler, the Australian Minister for Health and Aged Care is on the line. Mr Butler, good morning to you. 


HADLEY: You've opened up Pandora's box here and a whole range of emotive things are being said, including by Mr Twomey at that presser in Parliament House two days ago. Are you responsible for sending people bankrupt? 

BUTLER: What I'm doing is following the advice of the most serious experts in our medicines industry, the group that has been set up by government for both political persuasions for decades, to give high level advice about the management of our Pharmaceutical Benefits Scheme, one of the best medicines systems in the world, I think. So, they advise us what medicines to list. You know, Ray, you were so active in the campaign to have Trikafta, the cystic fibrosis drug, listed for 6 to 11-year-olds - that's the advice they gave. They advise the conditions on which medicines are listed, so who gets them and what price and so on and so forth. This group advised the former government five years ago that for very common medicine - for chronic disease, that people are on sometimes for years, sometimes even for decades, so for cholesterol, for blood pressure, for heart disease, asthma, so on and so forth - that people be able to get a 60 day supply of their medicine instead of the current limit of 30 days.  

That's very common around the world, all of the countries we usually compare ourselves to like the UK, New Zealand, Canada, France, Germany, many others besides, they have 60 or even 90-day limits on the medicine they can get for chronic disease. Now, for one reason or another, the former government decided not to go with that recommendation. But I've had that advice updated to me, and I've decided to accept that advice because what it will do is halve the cost of medicines for 6 million patients who have chronic disease, many of them older, many of them on low or fixed income like the pension, who at the moment have to go to their GP at least twice a year to get a repeat script, often for a medicine that hasn't changed for them for years and years, and then go to a pharmacy every month. And every time they go to the pharmacy and often times they go to the GP now, they're shelling out money that the highest-level experts have said they shouldn't have to shell out. I can't just walk past that advice and say: oh, it's too hard, you know, the pharmacy lobby group might campaign against me. My job is to look after the interests of patients.  

And not only will this be an enormous hip pocket relief at a time of real cost of living pressure, but we also know it's good for people's health, because in those countries that have the ability to get 60 or 90 days' supply of medicines, the compliance with medication improves by as much as 20 per cent. Ray, your listeners would know, the time when people are most likely to go off their meds, most likely to go off their tablets, is at the end of a script when they can't get back into a GP to get a repeat, or you know, with busy lives they find it difficult to get into a pharmacy. Medication compliance is a really important way of maintaining health and this will be good for that as well -  

HADLEY: Sorry, go ahead. 

BUTLER: Sorry, I didn't answer your first question which was the impact on pharmacy.  

HADLEY: Yeah. 

BUTLER: The taxpayers will save money from this, there will be a return to the Budget of about $1.2 billion because every time you go to a pharmacy, the taxpayer pays the pharmacist a fee – what's called a handling fee. And we'll obviously save because people won't have to go to the pharmacy as often. But I've said over the last couple of days, every single one of those dollars that we save as a government will be plowed back into community pharmacy. So, it will go straight back into the businesses that Trent Twomey represents. Now, there will be a saving for consumers, and that will be about $1.6 billion over the next four years. But let's put that in context. Pharmacies earn about $25 billion every year. So, over the next four years, even with no growth, they’ll earn more than $100 billion and they grew by 30 per cent over the last four years, so it's likely to be much more than that. But even if it's only $100 billion, a saving of $1.6 billion is somewhere around 1 or 1.5 per cent of their revenue. Now, how on earth people have gone bankrupt in the 24 hours since I made this announcement is beyond my understanding of how bankruptcy works. Look, there will be a hit to the bottom line of pharmacies, but I think people need to put it in context. It will be around 1 to 1.5 per cent of the revenue that they declare their industry earns.  

HADLEY: And they're talking about, you know, a couple of hundred thousand, $180,000, something like that. Look, I know it's a juggling act and, you know, there are pharmacists attacking me saying, oh, why are you supporting the Labor Party? I said, I'm not supporting the Labor Party, I'm supporting what the recommendation is. And the recommendation has been sitting there in place for five years and for obvious reasons the previous government didn't want to attack it. You've come to the chair in a short space of time, and I commend you over Trikafta, and I commend you on this particular one. Because it gives - for people that aren't on medications - you're talking about going to the doctor twice a year, you get a repeat which allows you for that six month period, usually, then you have to go and get another repeat. And with this - being able to go in there and instead of, you know, getting 30 days worth, you get 60 days worth of your medicine, that means, of course. The handling fees halve, we understand all of that, the handling fees halve, but there's a benefit to the patient and it's about balancing those low-income earners and those pensioners who are the ones that rely on these medications for cholesterol, blood pressure and all the other things you mentioned.  

There's a benefit to them and that doesn't get mentioned by the pharmacy lobby, or Mr Twomey or anyone else, there's no talk about those people and the benefit to them. And I would also say that some of the larger retailers who are involved in the industry who market, and some of them advertise on this radio network, obviously, I don't think they're great fans of the Pharmacy Guild. I don't think they represent them. And I think there's a discord between them, that perhaps they need to have a talk to each other about whether they think it's as bad as perhaps Mr Twomey is making out.  

The other problem I have with Mr Twomey - and I’d mentioned it in our introduction – I pick up The Telegraph today and I pick up the Sydney Morning Herald and The Age, Warren Entsch, who he was a staffer for previously while still being a pharmacist, he wants him to go to federal politics. It makes me think that this is a precursor to an election campaign, either for the lower house or the upper house as Senator Twomey, as opposed to pharmacist Twomey. And that becomes a bit political to my way of thinking. I put that privately to the Opposition Leader and said, “:this bloke part of your firm?” And he came back to me – Dutton - and said, “no, he's not, and if he's done the wrong thing or hasn’t admitted to things, he should be dealt with accordingly.” But I mean on one hand he’s saying - Warren Entsch that is –ah look he probably is better off in the Senate because he's running a pharmaceutical empire. I thought he was a chemist. I didn't know he was a, you know, entrepreneurial type figure who's running a pharmaceutical empire. It doesn't seem like that, and then he's standing up representing the little corner chemist saying: I'm standing here, I don't want them in Coles and Woolies and Aldi, and all this. He's running an empire which would be diametrically opposed to what the bloke on the corner with his wife running a chemist would be all about, I would think. 

BUTLER: You’ll know, Ray, you've been around the health sector that lobby groups have sharp elbows and all of the people they represent are in their business to do good things to help people's health, to help people through really difficult times. It's a great industry for people to work in. But the job of the Federal Health Minister is to look after the interests of patients first and foremost. That should always be what the Federal Health Minister and state Health Ministers should be doing. Now, I think it's really important to know that even though doctors will have literally millions fewer consults because of this, because people won't have to go in every six months to get a repeat script, they will only have to go in once a year. All of the doctors’ groups have supported this. Trent Twomey has said there will be medicine shortages from this, which is complete rubbish. The medicines industry has supported this as well, the ones who actually make and supply all of the medicines, they say this is a good thing.  

But most importantly, patient group after patient group has come out and said this is good for the people we represent - Diabetes Australia, Asthma Australia, The Heart Foundation. The National Rural Health Alliance, for whom it’ll be really important because, you know, I live within 100 meters of a pharmacy because I live in a big city, if you're living out of town in a rural community, going to the pharmacy every month is a big deal. We're seeing that feedback from people who live in rural Australia, that the inconvenience of having to do this and shell out money when the medicines experts have said you shouldn't have to in Australia anymore, is even more significant in rural Australia than it is here in the cities as well. It’s been strongly reinforced to me that this is the right thing to do because patient group after patient group, the people who are going to benefit most, both in terms of their hip pocket, but importantly as well in terms of their general health. I'm convinced that no Health Minister should walk past this advice just because it's difficult to implement, just because it's going to give rise to a campaign from a lobby group. 

HADLEY: I might mention - I'm glad you mentioned the shortages, because that was a narrative early on in this, you know: oh, you know, we don't have enough supplies, they come internationally. And then all of a sudden, when that was dispensed with, it becomes: oh they’re going bankrupt, and the crying outside Parliament. So the narrative changes from I will attack them saying: well, it's not going to work because we won't have enough to dispense in the 60 day period and that means other people can't get the medicine. And when that was dispelled with - I think you said seven out of 300 might be in short supply in some areas - when that was dispensed with, it went to - at the heartstrings – oh, they’re going to go bankrupt. There's one final thing from a listener or a number of listeners, actually, older listeners. Could you ask the Minister what happens to the PBS script free program and is it impacted at all? 

BUTLER: That’s the safety net, so all patients only pay up to a certain amount over a course of a year. We cut that safety net, which is the maximum amount pensioners will pay annually for their medicines. We cut that by 25 per cent last year. So, we already did a big, big reduction in the maximum amount pensioners pay. So right now, the maximum amount a pensioner will pay across a year for all of their medicines, no matter how many scripts they're on, is $5.05 per week. Once you hit that safety net, everything is free after that. We're not proposing any other change. We've already made a huge cut to that safety net last year. And we're not proposing any other change to that this year. 

HADLEY: Ok, that answered that question. I appreciate your time is short though, so talk soon. Thanks very much. 

BUTLER: Thanks Ray, goodbye.


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