By Birrani Carter
Your epilepsy medication costs just $24.81 under the PBS. In the US, that same life-saving drug can leave patients nearly $1,000 out of pocket. Now, US pharmaceutical lobbyists—driven by political forces from Trump’s second-term agenda—are demanding Australians pay their price, threatening to dismantle the difference that saves lives.
When American Greed Meets Australian Healthcare
As global tensions over drug pricing escalate, Australia’s Pharmaceutical Benefits Scheme (PBS)—a cornerstone of affordable healthcare—is under threat. Donald Trump’s push to slash United States drug prices has triggered a trade confrontation that now places our PBS in the crosshairs.
Australians pay just a quarter of what Americans do for medicines. That affordability is no accident, but the result of decades of careful policy. Now, the Albanese government faces a critical choice: reform the PBS’s sluggish approval process or risk losing the system that millions rely on.
What hangs in the balance is whether life-saving medicines remain accessible to all Australians, or become a privilege rationed by those who can afford skyrocketing prices.
The Death Tax: When Medicine Becomes a Luxury
Trump’s claim that Americans pay nearly three times more for medicines than other developed countries has sparked a global reckoning. United States pharmaceutical giants are demanding that countries like Australia stop receiving better prices, framing Americans as “subsidisers” of foreign health systems.
“Patients will die waiting for new medicines,” warns Medicines Australia CEO Liz de Somer, referencing the PBS’s notoriously slow approval system.
This is not just a policy debate. It is a question of survival. If affordability collapses, the consequences will be measured in lives lost and families bankrupted.
466 Days to Die: The Bureaucratic Death Spiral
Australians wait an average of 466 days after regulatory approval before new drugs are listed on the PBS. That is over 15 months of delay, whilst patients overseas begin treatment.
Christine Cockburn from Rare Cancers Australia describes families remortgaging homes or turning to crowdfunding to pay for treatments costing hundreds of thousands of dollars. These are not rare cases, but the human cost of bureaucratic inertia.
Australia’s PBS uses rigorous cost-effectiveness reviews to protect taxpayers. But when that caution becomes paralysis, it denies patients timely access to life-saving innovation.
Butler’s Betrayal: How Politics Trumped Patient Lives
Last year’s Health Technology Assessment (HTA) review offered hope, with bold proposals aimed at cutting approval times to six months for 90 percent of new drugs. But nearly a year later, Health Minister Mark Butler has only installed an advisory group. Implementation is now delayed until 2026, a timeline experts have called “unconscionable”.
Meanwhile, industry groups are pushing for even faster listing—down to 60 days—raising fears of ballooning costs for taxpayers, who already fund a $14 billion annual scheme.
To accelerate access without compromising integrity, we must:
- Fast-track HTA recommendations
- Adopt clear accountability timelines for each review phase
- Increase transparency so patients and clinicians know where every medicine stands
Big Pharma’s Ultimatum: Pay Up or Patients Die
Lipitor, a commonly prescribed cholesterol-lowering medication, costs American patients up to $2,600 per year. Under the PBS, it is capped at $31.60 per prescription—representing a fraction of that cost. That vast difference is precisely what US pharmaceutical lobbyists want to eliminate.
“This isn’t about fairness. It’s about dismantling the only systems that restrain their profiteering,” argues healthcare economist Dr Stephen Duckett.
If Australia’s unique negotiating monopsony falls, Duckett warns, Canada and Europe will face identical pressure. The PBS is not just a national achievement, but a global model of resistance against unchecked pharmaceutical pricing.
We’ve Sold Out Before: The 2004 Surrender That Cost Lives
We have bowed to US pressure before. In 2004, the Howard government’s US-Australia Free Trade Agreement weakened our generic medicine protections. The introduction of complex “F1/F2” drug categories led to shortages and higher taxpayer costs, whilst drug companies profited.
Today, US tariff threats endanger our $2.2 billion pharmaceutical export industry, with homegrown hero CSL particularly exposed. Health Minister Butler insists the PBS is “off limits”, but seasoned negotiators warn that side agreements and regulatory coercion have eroded protections before.
The Last Stand: Reform Fast or Lose Everything
Australia must urgently reform and streamline PBS approvals, not only to protect patients, but to undercut American arguments about “unreasonable delays”. At the same time, surrendering our affordability system would be catastrophic.
Prime Minister Albanese calls the PBS “a monument to fairness” that Australians will not negotiate away. This political resolve is critical as we join allies like Canada and the European Union in resisting US-driven attempts to dismantle subsidised drug systems.
“Our patients can’t and shouldn’t pay the price of US-style healthcare,” reminds Dr Michael Wright, President of the RACGP.
By forming strong alliances, we can resist attempts to make affordable medicine a relic of the past. Canada has already faced a US trade complaint over drug pricing. The EU is locked in battles to defend its cost-control systems. The pressure is real, and growing.
The Line in the Sand: Australia’s Moment of Truth
The PBS is one of Australia’s greatest public policy achievements. We must decisively reform its delays, strengthening accountability and speed, without ever sacrificing the principle that medicine is a right, not a privilege based on postcode or bank balance.
The world is watching. Will we cave to pressure, or defend the right to affordable medicines for all?
Frequently Asked Questions
What is the PBS and why should I care?
The Pharmaceutical Benefits Scheme (PBS) keeps your prescription medicines affordable. Without it, you’d pay what Americans pay—often thousands of dollars for treatments that currently cost you under $50. It’s one of Australia’s most successful public health policies, but it’s now under threat.
Why do new medicines take so long to get PBS approval?
New drugs wait an average of 466 days (over 15 months) for PBS listing after being approved as safe. The government conducts rigorous cost-effectiveness reviews to protect taxpayers, but this cautious process can delay access to life-saving treatments.
What’s the HTA review and why has nothing happened?
The Health Technology Assessment review proposed cutting approval times to six months for 90% of new drugs. Despite being completed last year, Health Minister Mark Butler has only formed an advisory group. Real implementation won’t start until 2026—a timeline experts call “unconscionable”.
How is the US threatening our affordable medicines?
American pharmaceutical companies claim US patients subsidise lower prices in Australia. They want Australia to pay more—turning your PBS cost of $31.60 per prescription into nearly $2,600 a year, the price Americans face. Trade pressures originating in the Trump era could force Australia to abandon the PBS pricing model that keeps medicines affordable for millions.
Have we caved to US pressure before?
Yes. The 2004 US-Australia Free Trade Agreement weakened our generic medicine protections, creating drug shortages and higher costs. Industry experts warn similar concessions could happen again under current trade threats.
What happens if we lose the PBS?
Families would face hundreds of thousands of dollars for cancer treatments. People would remortgage homes or turn to crowdfunding for medicines. Australia would join America as a country where your postcode and bank balance determine whether you live or die.
What can be done to save it?
Australia must speed up PBS approvals to undercut US arguments about delays, whilst absolutely refusing to abandon affordable pricing. We need strong alliances with Canada and the EU to resist pharmaceutical pressure globally.
© 2025 South Burnett Advocate (kingaroy.org)