We discuss what could be a significant policy shift in PBS decision-making, with clinical judgement backed by what is a 'common sense' outcome. It could be a new precedent, but only if all stakeholders demand clarity on the criteria so that it can be applied more broadly. We also reflect on patient advocacy in New Zealand, where access has become a political issue and the focus of a significant discussion at this week's Valuing Life Summit in Wellington.

Has Senate Estimates devolved into an overly polite, time-sliced format that enables waffle, obfuscation, and endless questions taken on notice? Does this reflect weakened scrutiny? The responses provided revealed the truth of review processes, which aim to protect institutional power, blame outsiders for problems, and generally add complexity to existing problems. Few appear willing to say the quiet part out loud.

Listen on Apple or Spotify.

We open by marking Yom Kippur and a frank discussion before pivoting to the US 'MFN' drug-pricing moves, what they could mean for Australia’s PBS, and why institutional rigidity in HTA persists and is worsening. Medical research funding rhetoric versus slow progress in PBS and health technology access, hospital funding and NDIS pressures, and the expansion of pharmacist prescribing, as well as the need for subsidised pharmacy services.

On the Dispatched Podcast this week, we reflect on the erosion of public confidence in health decision-making. Former Victorian Chief Health Officer Brett Sutton’s admission that some COVID-19 measures were not strictly evidence-based highlights the need for a Royal Commission, which would have compelled accountability and helped restore trust.

The discussion then turns to MSAC’s rejection of newborn screening for Pompe disease. Health Minister Mark Butler must intervene, not least because he has previously pledged support to affected families.

Looking abroad, Australia can look to New Zealand’s overhaul of Pharmac, particularly its decision to bring in external leadership and critics. It provides a model for cultural reform. In contrast, Australia’s system is mired in the same conversations among the same insiders.

The podcast closes on the Trump administration’s proposed 'Most Favored Nation' pharmaceutical pricing policy and the new 100 per cent tariff. The Albanese Government, they predicted, would adopt a wait-and-see approach, shaped by a long history of industry warnings about lost access to medicines that rarely materialised.

In this week’s episode, the Medical Services Advisory Committee’s rejection of adding Pompe disease to newborn blood spot screening is condemned. The decision is contemptuous, inhumane, and riddled with fabricated justifications based on made-up terms like 'parental hypervigilance'. Families’ lived experience highlights the devastating cost of delayed diagnosis. The committee ignored evidence, misused language, and hid behind flawed economic models while dismissing patients. Health Minister Mark Butler and the Prime Minister can show moral leadership and finally honour their promises of 'never again'.

Patients should never accept a decision-making framework that requires them to sacrifice themselves for a mythical collective good, which is just the government getting the best deal for itself. More evidence of why we need to know what discussants present to HTA committees, and how they reflect personal opinions and ideologies. Financial results that confirm pharmacy's increasing role as a health destination.

The minister focused on NDIS reform at this week's National Press Club address, suggesting that it is taking up a lot of his time. Implementing the HTA Review will be one side of a two-sided coin. While it might frustrate some, it represents a unique opportunity to secure positive outcomes from an inevitable negotiation.