The 'Dispatched' Podcast

This week, we mark a significant anniversary, discuss the risks of missing the opportunity that artificial intelligence offers to speed access to healthcare, and explore why some might be reluctant to embrace it. The wonderful irony of the phrase of the week.

This week's discussion starts with the perfect example of why pulling one lever can trigger another. The Senate's considering changes to expand the regulator's power, without any submissions from those most affected. Is it possible to have a common-sense discussion about tobacco excise against the backdrop of an unrelenting crime wave with mounting numbers of innocent victims? Or can those not impacted by the consequences just turn the other cheek? Sound familiar?

Why pulling the same 'levers' on reform cannot work. Comparing one medicines access program and its humanitarian underpinnings to our institutional frameworks. The need for term limits on advisory committees, the enduring unfairness of medicine co-payments, and the phrase of the week.

The opportunities available in the pending negotiation of new industry agreements and the selective discrimination against some patients and patient groups by an outdated and unaccountable institution.

For more than a decade, Public Summary Documents have been presented as evidence of system transparency, but in fact, they are an affront to it. What was the discussion about transparency that ended with an impenetrable 50-page technical document as the solution? Who remembers that the PBS still has 'Special Patient Contributions'? Also, a new guide on talking about the deception that are the agreements euphemistically described as 'risk shares'. Read the BAA guide to risk share arrangements.

An important reminder about the impact of innovation and why it matters. What does it say about Australia and our life sciences policy frameworks that locally developed innovations are commercialised in other markets, but not here? Patients need access to the rights they are currently denied and the 'Abilene paradox'.

The events in the US this week surrounding a former public health leader raise some important questions in Australia about the accountability of 'independent experts'. Why we can't afford to muck up the AI opportunity as new evidence on its use emerges globally. Ongoing debate over access to medicines and the impact of global pricing.

Misleading claims about patient groups and the industry, combined with an irrational hyperventilation about a rational response to new global realities, have made for an interesting week. The price reduction mantra and whether it can be moderated?

A very busy week with mostly relief for patients accessing PBS-funded multiple sclerosis medicines, but what does it really mean, and what is the opportunity? Reports and their questionable citations. The most cynical use of language in our health system.

The MS medicines controversy continues. Why wouldn’t the minister just deal with it and make it go away? It may not be that easy. Why any resolution will probably deal with symptoms rather than the cause. The realities of ministerial offices and the challenges they face that are not visible to outsiders. Another 'phrase of the week' is dissected to reveal its true meaning.

A small player with no market share and no real prospect of gaining any agreed to an almost 50 per cent price reduction to secure reimbursement. Who would have thought the market leaders would respond negatively? Discussion about the change to nurse prescribing, which has been a feature of the PBS for more than 15 years, and concerns over vaccine hesitancy.

Congratulations to one of Australia's leading health journalists on a highly effective series of stories and commentaries that reveal the true extent of this country's challenge and the problems patients face in accessing medicines. A welcome hardening of the research-based industry's public position on the need for change, a very good report on a needed health technology, and another 'cheap' outcome for patients.

The emerging impact of China's use of international reference pricing might pose a significant risk to access to medicines in Australia. The critical importance of detail and getting the basics right when negotiating with the government - its ability to operate so effectively in the detail is how the government succeeds in these negotiations. Phrase of the week!

Why long-term thinking and planning are the key to success. What is the ten-year goal, and how does a new agreement progress that? Plan for policy and government engagement like it's a product launch. Also, is the problem with the HTA Review the process or the expectation? How a different starting point would have made this outcome positive.

Where did these industry agreements come from, and why? In the first episode of a two-part special, we discuss the genesis of the Australian government's agreements with the industry, based on personal experience, why they emerged as a solution to a decade-old challenge, and the problem they were aiming to solve. The opportunities, the risks, the vulnerabilities, and the importance of understanding how we arrived here.

Powerful patient stories stand in contrast to a decision-making framework that explicitly dehumanises their lived experience. The need for 'decency and compassion'. Week one of Senate Estimates, the challenge of saying one thing publicly and something else privately, and a Budget that revealed so much about what is coming.

There are enough measures and signals in this week's Budget to suggest medicines, vaccines and other technologies were discussed extensively in the process leading up to Tuesday's announcement. It might also help explain Health Minister Mark Butler's annoyance at one organisation's response. A Government response to a parliamentary inquiry triggered another odd response from stakeholder groups.

In this week's episode, the focus is on the latest example of no progress on reform, the mindset and intransigence it reveals, the repeated pattern, and the early evidence that it would always end this way. Can it be an opportunity? Next week's Budget is upon us, and the discussion focuses on what to look for, that just because it is not in there, does not mean it is not in there, and why gaining any cut-through will be a real challenge.

In this special episode, the focus is on the official plan to force a 'consensus' on health technology assessment reforms through a process conducted in secrecy under the guise of ethics approval. The problem with running this policy process like a clinical trial is that we do not and will not know the identities of participants, how they were selected, their input, how it is used and weighted, or even the study protocol.

Tokenistic characterisations of patient engagement are no substitute for listening and empowering. The risk of government funding for organisations and how it can impact what they do, primarily because the government is just another vested interest.