Erika Turkstra and her team provide expert assessments on submissions from pharmaceutical companies seeking government subsidy of a pharmaceutical or vaccine through listing on the Pharmaceutical Benefits Schedule (PBS). The submissions need to demonstrate that the product is cost-effective, i.e. provides value for money. The submissions are critically appraised including a judgment on their indicated use, target population, the adequacy of patient information provided, the clinical efficacy, and the statistical analyses of clinical and economic value. The economic evidence that needs to be analysed usually involves a detailed review of the economic models presented (including the structure of the model, clinical pathway, errors in data entry or in variables).
Since the start of the project, we have been involved in more than 80 critical appraisals and four therapeutic group reviews. Due to our involvement, the Pharmaceutical Benefits Advisory Committee (PBAC) has approved many of the medications and this has resulted in over 500,000 patients being able to receive new clinically effective treatments at a cost to the government of less than $250 million per year. Many submissions were rejected, based on inadequate evidence of clinical effectiveness and/or cost-effectiveness. If these medications would have been listed they would have resulted in a cost to the PBS of over $700 million per year.
Therefore, our work over the last six years alone was pivotal in the allocation of almost 1 billion dollars annually in this country, affecting hundreds of thousands of patients. The cumulative impact will be even higher.