Efficient Funding of Chemotherapy (EFC) Review – Interim Report

Overview

The EFC Program provides funding for chemotherapy and other medicines used for the treatment of cancer that are administered through infusion or injection at public or private hospitals. Not all cancer medicines are provided through the EFC Program; some may be subsidised through other sections of the broader Pharmaceutical Benefits Scheme (PBS).

The Australian Government is undertaking a review of the EFC Program to examine current EFC arrangements and the associated practices within the supply chain to ensure continuing access to these medicines, and whether the EFC Program supports patient access to chemotherapy medicines in an efficient and cost-effective manner.  

Informing the EFC Review are Professor Sanchia Aranda as Lead Reviewer and Associate Professor Richard De Abreu Lourenco and the Centre for Health Economics Research and Evaluation at the University of Technology Sydney as the Health Economics team.

The EFC Review Terms of Reference were released on 25 January 2021. A Discussion Paper was published on the Departments Consultation Hub for public consultation from 21 May 2021 through to 2 July 2021. A total of 40 response submissions were received. Following the Discussion Paper consultation phase, the EFC Review team engaged with EFC supply-chain stakeholders to discuss the key themes identified from submission responses.

The submissions and consultations demonstrated the complexity of the cancer medicines supply chain, including its specialised nature and the interconnectedness between the EFC reimbursement arrangements and commercial activity, and the impact of funding and supply chain arrangements on prescriber behaviour. The EFC Review has focused on understanding these arrangements and explored opportunities to reduce complexity, increase efficiency and sustainability, ensure accountability, and improve overall access for people affected by cancer.

While the majority of stakeholders maintain the EFC Program is a valuable mechanism promoting access to cancer medicines, the provision and remuneration of cancer medicines is only one part of ensuring equity of access to high-quality cancer services for all eligible Australians. Many of the submissions raised issues of access to quality cancer treatments that were outside the scope of this current review. To ensure these matters are noted and to assist future efforts on improving access for cancer medicines, a supplementary report outlining the out-of-scope concerns will be included as part of the Final Report to the Department of Health and Aged Care.

Consultation on key findings and recommendations

The Interim Report from the EFC Review team presents the key findings and recommendations from stakeholder input.

This consultation process represents the final opportunity for EFC supply chain stakeholders including patients, clinicians, pharmacists, hospital administrators, cancer medicine manufacturers and compounders, peak bodies and state and territory health services to provide further input and comments to the EFC Review. Input to this consultation will be considered by the EFC Review team and will inform the EFC Review Final Report. 

Stakeholders are invited to provide further comments to the Review in the following areas:

1. Do the findings, as presented in the EFC Review Interim Report, contain any misrepresentations?
2. Are there any key matters, within the scope of the EFC funding arrangements, that have been omitted from the EFC Review Interim Report?
3. Is there further information, relevant to the analysis generated in the EFC Review Interim Report, that has become available since the Discussion Paper consultation phase?
4. Are there further factors to be considered, in refining the EFC Review Interim Report recommendations?

The EFC Review Interim Report can be viewed and downloaded via the link below.

All input into this consultation must be provided via the Consultation Hub and in the format requested.

Consultation is now open and will close at 11.59PM AEDT on 28 October 2022.

Privacy Notification

The Department is bound by the Privacy Act 1988 and the Australian Privacy Principles (APPs).

The Department is collecting personal information about you in this consultation for the purposes of informing the Review.

The collection of this information is required to inform a review of the efficiency, effectiveness and appropriateness of the EFC for the PBS.

While the Department encourages respondents to self-identify in their submission, there is no requirement to do so. However, if for example, should you choose to make an anonymous submission, the Department will be unable to attribute views to you in the Review Report, or follow-up with you on any issues that you raise. The Department will seek your permission before attributing your views in the Report.

The Department has an APP privacy policy which you can read at http://www.health.gov.au/internet/main/publishing.nsf/Content/privacy-policy

Why your views matter

Submissions received as a result of the consultation on the Interim Report will support the Department of Health and Aged Care in developing a Final Report for the Minister to consider.