KIERAN GILBERT, HOST: Let’s go live to the Minister for Health Mark Butler in Adelaide. Minister, thanks for your time. Michaelia Cash is saying because our relationship with the US is not strong, the Prime Minister can’t pick up the phone and make our case when it comes to these new pharmaceutical tariffs. Does she have a point?
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: These are tariffs that were announced by the American Administration last week that apply to every single country on the planet. We are making our case very forcefully to the US Administration about the benefits of the free trade that we’ve enjoyed between our two countries for 20 years. We’ve now been granted the lowest possible tariff position of any other country on the planet as well, but of course we’ll continue to make the case about pharmaceutical exports going into the US, particularly as we better understand the impact of the announcement the President made a few days ago.
GILBERT: Are you worried about the impact on industry? You said a couple of days ago that you’re going to look at the impact on Australian pharmaceutical companies. What impact is it going to have?
BUTLER: The vast bulk of our exports to the US are actually blood and plasma products so it’s not entirely clear whether they are captured by the scope of the announcement the President made a few days ago. Also the President said there would be exemptions from those very high tariffs of 100 per cent if a company was involved in capital investment in the US and the major exporter of our blood and plasma products is in the process of building even more facilities in the US than they already operate there with many, many thousands of employees employed in the United States undertaking that blood and plasma product’s work. It’s certainly not nothing. There are some medicine exporters that may be captured by these tariffs if they do go ahead. The US is an important first market, if you like, for start-up medicine companies because getting access to FDA approval is terrifically important in terms of global exposure for a new medicine. But we are trying to understand this impact a little bit more. We do think that there is a very high likelihood the major exporter that accounts for the vast bulk of our exports to the US will not be captured by this new announcement, either because of the nature of their products or because of the capital investment they’re undertaking right now in the US.
GILBERT: The Prime Minister said in his interview with Andrew earlier in the program that Australia pulls it weight, in fact we punch above our weight when it comes to relations with the United States. Does that extend to this area as well when it comes to health?
BUTLER: I think it extends to all of our trade arrangements and that’s why in a very volatile environment and volatile period we have now been granted the lowest possible tariff rates by the US Administration that any country enjoys over the rest of the world. That actually means that we get a competitive advantage when we are competing in the US market with countries that have a higher tariff rate applied to their country than Australia has which is, of course, the lowest rate of 10 per cent. Now, pharmaceuticals are a particular focus of the US Administration. The President has indicated for understandable reasons that he wants to see drug prices lower for US patients and they currently are. They’re among the highest in the world and several times higher than the average drug prices you see in the OECD. We’re working very hard to understand what the impact that might have on Australia is going to be and make sure that we pursue the national interest for Australia. That’s our job as government politicians and Ministers. It’s certainly the job that Kevin Rudd is undertaking as our Ambassador with all of his highly talented officials.
GILBERT: Is the PBS, I know you’ve got an important listing impacting many Australian women. I want to ask you about that in just a minute, but just the PBS broadly, is that at any risk at all under this tariff threat?
BUTLER: We’ve said that the PBS for 80 years or so has been one of the core pillars of Australia’s health care system, one of the reasons why we are consistently rated as having one of the best health care systems in the world, particularly for health equity and particularly for health care outcomes. Australians enjoy access to the cutting edge medicines, the best available medicines anywhere in the world at very affordable prices. Prices that we’ve actually made even more affordable with our cheaper medicines policies. From a Government point of view, particularly a Labor Government point of view, that is not going to change. We are going to make sure that Australians continue to enjoy good access and high affordability. But of course, what the US Administration is doing as such a big player in global pharmaceuticals, such a big part of the global market, what they are doing is of course going to reverberate through the rest of the world and we are working very hard to make sure that we understand what the Administration is intending to do because frankly, that is changing from time to time.
GILBERT: But you won’t budge on the PBS?
BUTLER: We won’t budge on the PBS. We said we won’t negotiate on the PBS. Obviously, we may have to adjust our thinking about what's happening in the global market. This is not just decisions of the US Administration. That will impact some of the decisions that global pharmaceutical companies make and we've got to make sure that we're still an attractive market for those companies sending new medicines to Australia, like the medicines that I'm announcing will be listed this week on the PBS for women with metastatic breast cancer. That obviously is one of the most important jobs of any Australian Health Minister.
GILBERT: Yes, so on that listing, how many women are going to benefit from the better access, the cheaper access to what can be a life-changing drug?
BUTLER: That's right, this terrific new medicine, TRUQAP, a medicine sponsored by AstraZeneca, will be listed for the first time on the PBS from the 1st of October. It's available for women with metastatic breast cancer of a particular type, HR positive, HER2 negative, which accounts for about 70 per cent of all breast cancer cases. It's a very wide-ranging drug. The company thinks as many as 3,000 women with metastatic breast cancer will have access to this at PBS prices. It currently costs them around $100,000 for a course of treatment. That will now be available from Wednesday at just PBS script prices, which from 1st of January will come down to just $25 a script. Metastatic breast cancer still kills a large number of Australian women. Only about one in three women with metastatic breast cancer survive more than five years. Although, broadly speaking, we have terrific survival rates, some of the best in the world for breast cancer broadly, we do need to improve survivability for metastatic breast cancer and this new drug listing will go a long way to doing that.
GILBERT: Well, that is good news and we hope that it does have that tangible impact on survival rates. I want to ask you about the impact on pregnant women around Australia and of the advice from Donald Trump and his Health Secretary. What are you saying to them about the use of paracetamol? Is it safe or not?
BUTLER: I checked very quickly with our medicine authorities, the Therapeutic Goods Administration and the Chief Medical Officer. I wanted urgent advice about whether there was any reason for our authorities to change their advice about the use of paracetamol or Panadol, as it's commonly known here in Australia, in light of what the Americans had said at that press conference with the President and the Health Secretary, R.F.K. Jr, and very quickly our authorities said that they stood by their advice. You'll see that reflected by other authorities around the world, like the UK, but also by our peak scientific and medical bodies here in Australia. There have only been two very recent studies reaffirming the long-standing held position that there is no causal link between paracetamol and autism. Indeed, it is an important drug for pregnant women to have available to them particularly if they are suffering fever because what we do know is that untreated fever can be very dangerous, not just for the pregnant woman herself, but also for the foetus. We were very determined to make sure we got the best advice back to pregnant women. There's more than 200,000 women who are pregnant in Australia today so that they could be confident and not unsure and certainly not afraid about using this very important medicine, one of the most researched medicines in the world.
But I'm still worried about the uncertainty and the fear and in some cases I fear the shame that has been caused by this announcement. I was only told yesterday about a mother whose 10 or 11 year old child with autism asked her whether she had taken Panadol when she was pregnant. These announcements do have reverberations. I've been determined as much as I can as the Health Minister to give pregnant women, their families, women who have an autistic child and may have taken Panadol while they were pregnant, the advice that demonstrates very clearly there is no causal link between these two things.
GILBERT: The issue with some of the studies cited, is it not, you correct me if I'm wrong from the experts that you've got in the TGA and elsewhere, but is it not that some of the studies have looked at situations where women might have a fever or something else and that could well have been the causal link to any subsequent autism or whatever else for their child as opposed to the treatment they might have taken?
BUTLER: That's right. There are studies right across health that sometimes do show correlation, but that's very different to showing causation, a causal link between one thing and another, in this case paracetamol and the possibility of autism. As I said, only last year a very big Swedish study tracking 2.4 million children came to the view there was no basis to think there was a causal link. This year a very big Japanese study said exactly the same. This is a very, very deeply researched medicine and the overwhelming bulk of evidence indicates that it is safe to take. Indeed, it is often the safest option because there are other fever and pain medications that are not as safe as paracetamol. It is safe to take provided you take it, of course, in accordance with the directions. Chronic overuse of paracetamol, like anything, might be dangerous, but if you use it in accordance with the directions, the overwhelming bulk of evidence, including these two very recent, very large, respected studies, show that pregnant women should feel confident that they can use this if they are sick, particularly if they have a fever.
GILBERT: Are you concerned the message out of Washington might have a cooling effect on the uptake of vaccines?
BUTLER: We're broadly concerned about the position around childhood immunisation. We've had 13 quarters in a row, that's more than three years in a row of declining rates of childhood immunisation and we are seeing that right throughout the world. The World Health Organization says there's more than 100 countries where immunisation rates for under five-year-olds are dropping, not holding steady. That's a very great concern to me as the Health Minister. Immunisation, for example, for measles, mumps and rubella, that MMR combination vaccine that your little one gets at 12 months and then a second dose at 18 months is dropping below herd immunity levels and in some parts of Australia is well below 80 per cent. Herd immunity is about 95 per cent. There are some places in Australia where it is dangerously low and if measles gets into those communities, babies are very vulnerable. We know that measles can be a very, very serious disease for babies and sometimes can actually be fatal. We're seeing more measles cases this year in Australia than we've seen for a number of years. Most of, the vast bulk of them return travellers, bringing measles back from overseas. But if that gets into a community where there are low rates of immunisation among their babies, I'm very worried that we're going to see some of the things we're seeing right now in parts of the United States.
GILBERT: Finally, before you go, the Prime Minister wrapping up his commitments in the United States and the UK. The Opposition Leader says he shouldn't be at the Labor conference in the UK. Michaelia Cash this morning said that Mr Albanese is the leader of Australia and he's not there as the leader of the Labor Party. What do you say to the criticism that the Liberal Party is directing at the PM for attending the British Labor conference?
BUTLER: The Prime Minister was invited by the UK Prime Minister to speak at that conference. He conducted a number of meetings with other UK cabinet ministers about things that are very important to our country, including obviously AUKUS which is a critically important issue for us and the UK and obviously the US as well. I just don't buy that politicking from Sussan Ley and Michaelia Cash. The Prime Minister has been working very hard over the last several days pursuing Australia's national interests, meeting with world leaders but also in the UK's case with UK cabinet ministers. This is still a very important country for Australia. Our second biggest source of foreign direct investment is still the UK. Our second destination of Australian investment is still the UK. Of course it's important that our Prime Minister would engage deeply with that government.
GILBERT: Senator Cash deriding the PM's commitments at the UN saying all he got out of it was a selfie.
BUTLER: If anyone watched what was happening through that leaders’ week, you'll see that the Prime Minister met with many, many world leaders. He had the opportunity to promote Australia's world leading reform on social media access for under 16 year olds. This is an area where we are again leading as a country but it is important that we see other countries follow our lead. It will be much easier for us to implement these reforms in a meaningful way if other countries follow our lead and big tech sees the message from the world, not just from Australia, that we're determined to protect our kids. We're able to undertake serious work around climate as well as obviously staking out our position in relation to Palestine. The idea that this was not a very, very filled agenda where a lot of Australia's national interest was able to be pursued by the Prime Minister most importantly but also Foreign Minister Wong and other ministers again is just some pretty cheap politicking.
GILBERT: Health Minister Mark Butler joining us live from Adelaide. Thanks for your time.
BUTLER: Thanks Kieran.
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