PBS Reform Critical to Accessing Medical Breakthroughs
Sponsored by Pfizer Australia. We are witnessing an extraordinary medical revolution. Advances that once belonged in science fiction, such as regenerative medicine to repair damaged organs or AI-driven diagnostics for cancer detection, are rapidly transitioning from research to real-world treatment. However, a critical question arises: do Australians have timely access to these exciting medical innovations?
Australia's PBS System and Its Challenges
In Australia, the Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicines, enabling Australians to access them at an affordable price. The 75-year-old PBS provides approximately 5,000 medicines for 17.8 million patients annually, with patients paying at most $25 per script, and the concessional co-pay capped at $7.70 until 2029. These medicines treat a wide range of chronic and acute illnesses, including heart disease, stroke, diabetes, arthritis, and mental health conditions.
Despite this, Australia publicly funds only a fraction of the medicines available in other countries. Of all new medicines launched globally between 2012 and 2021, merely 24 per cent have been publicly funded in Australia. More than 1,000 submissions for innovative medicines—deemed safe and effective by the Therapeutic Goods Administration (TGA)—were rejected or deferred for inclusion on the PBS between 2010 and 2019.
Impact on Patient Access and Delays
In practical terms, some Australians miss out on the best available treatment for their conditions. Patients may choose to pay out of pocket or travel overseas to access therapies, but the costs can be substantial, imposing a significant financial and emotional toll. For medicines that do make it onto the PBS, patients typically face long delays. On average, it takes 466 days from when the TGA approves a medicine for it to be funded on the PBS. This is 100 days slower than the OECD average and 300 days slower than countries like Germany, Japan, and the UK.
A System No Longer Fit for Purpose
Australia's evaluation system, designed decades ago, has not kept pace with today's rapidly evolving science. There is a pressing need for an agile system of assessment, approval, and reimbursement built for the 21st century. Additionally, spending on the PBS is declining. Net spending on the PBS as a share of total health expenditure fell by $120 million from $12.671 billion in 2023-24 to $12.558 billion in 2024-25. Over the same period, Australia's population grew by around 420,000 (to 30 June 2025) and continued to age, meaning demand for PBS-listed medicines is rising even as PBS spending falls.
Australia now languishes at 19th in the OECD on spending on medicines, behind many lower-income nations. Policymakers must shift their perspective on medicines spending—from viewing it as a cost to recognising it as an investment in the nation's health, productivity, and future. It has been estimated that new medicines added to the PBS between 1994 and 2011 saved almost $6 billion, as sick Australians required 2.5 million fewer days in hospitals than would have been the case without them.
The Cost of Inaction and Future Opportunities
When people receive effective treatment early, they are healthier, more productive, and less reliant on hospital care—a benefit that extends across entire communities. The opportunity before us is immense: a new medical frontier capable of transforming lives, extending longevity, and strengthening our health system for generations, allowing more Australians who want to be in paid work to contribute to economic prosperity. Harvard University researchers speculate that a child born today might live to 150, compared to a century ago when Australians lived to only about 55.
Seizing this opportunity requires modernising how we value, approve, and fund the medicines that could define the next century of Australian health and wealth. We encourage Australians to reach out to patient support groups or their Federal Member of Parliament to discuss how an improved PBS can benefit everyone.
