Affordable access to innovative cancer medicines - don't forget the prices.

In Australia, HTAs for medicines are carried out in two phases. First, a pharmaceutical company makes a submission to the Therapeutic Goods Administration, which assesses a medicine’s efficacy and safety. If the medicine is approved, an application can be made to the Pharmaceutical Benefits Advisory Committee (PBAC) to have the medicine subsidised by the Pharmaceutical Benefits Scheme (PBS). The PBAC assesses whether the medicine is cost-effective in comparison with existing therapies. For targeted therapies, approval may also be sought from the Medical Services Advisory Committee for “companion diagnostics” that determine whether patients are likely to respond to the treatment. If medicines are not subsidised by the PBS, patients and their doctors have to find other means to gain access to them, which may include enrolling in clinical trials, seeking treatment through public hospitals or appealing to pharmaceutical companies for free or subsidised access. If unsuccessful, patients are left with the pressure of raising the money themselves or having to forgo treatment.