All users of Australia’s Pharmaceutical Benefits Scheme (PBS) need to pay at least some contribution to the cost of their medicines, the National Commission of Audit has told the government.

The Commission says co-payments for all general patients should go up  A$5.00, from A$36.90 to A$41.90 for those whose costs are below the safety net, and from A$6.00 to A$11.00 for those with costs above the safety net.

To ensure people make a greater contribution to meeting their own pharmaceutical needs and ensure the Budget is not adversely impacted by the increased co-payments, the general patient safety net should be increased from A$1,421.50 to A$1,613.77, it adds.

The Commission also says that the current A$6.00 co-payment paid by concession card holders should not be increased - until they reach their safety net threshold of A$360.00, after which they should pay a co-contribution of A$2.00.

“The Commission considers that introducing a co-payment would be an important step in providing a signal to users about the cost of their care and place greater value on these medicines, potentially reducing the incentive that users face not to take their medicines,” says the report.

However, industry patient groups alike have condemned the recommendations, with the Consumer Health Forum (CHF) calling them “an ideological prescription for the end of Medicare” which would create a two-class health system.

Research commissioned by the CHF shows that “co-payments won’t save money and will in fact exacerbate health conditions through treatment delays, particularly for the poor, aged and those with chronic conditions,” said the Forum’s CEO, Adam Stankevicius.

And research-based industry group Medicines Australia said the Commission report was “a fundamentally flawed” analysis of the PBS, with some of its recommendations suggesting “the Commission of Audit has been drinking the Kool-Aid.”

“The fact is the PBS is sustainable and needs no further savings measures,” said the group’s chief executive, Brendan Shaw.

“Access to life-saving medicines means Australian patients can afford and receive new medicines coming into the country, but these new medicines may not even make it to Australia if some of the recommendations in the Commission’s report are implemented,” said Dr Shaw. 

The report is effectively calling for a system similar to that in New Zealand, and if that were to happen, “you can kiss the Australian medicines industry goodbye,” said Dr Shaw.

“If the government is relying on this industry to drive economic growth, this is not the way to do it,” he said.

The recommendations are contained within Phases I and II of the National Commission of Audit’s report, Towards Responsible Government. They also call for new drug approvals through the Therapeutic Goods Administration (TGA) to be streamlined by recognising approvals made by overseas agencies such as the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA).

- The Commission was set up by Ministers last October to review and report on the performance, functions and roles of the government.