4 ms·

But millions per patient is the exception, most people don't have that spent on them, thats why it averages out, and why countries like Australia can afford pub

But millions per patient is the exception, most people don't have that spent on them, thats why it averages out, and why countries like Australia can afford public health care.

fastball 6y ago
So Australia does not have any caps whatsoever on what they will spend for disease X?
- angry_octet 6y ago
  We spend far more money on widely prescribed drugs like statins. The most expensive drugs are rarely needed by many people. The big one recently is a drug to treat Hep C, at about A$22000 a patient (but possibly saving years of dialysis) and a macular degeneration treatment (what price do you put in vision?). https://www.abc.net.au/news/health/2020-12-01/australias-most-commonly-prescribed-medicines-statins/12936626 https://www.abc.net.au/news/health/2020-12-01/australias-mos... From someone on the PBSAC: https://www.nps.org.au/australian-prescriber/articles/the-challenge-of-costly-drugs https://www.nps.org.au/australian-prescriber/articles/the-ch... It isn't so much the cost, but whether they actually work, or are any better than other treatments.
- chadcmulligan 6y ago
  Not that I know of, medications make their way onto the Pharmaceutical Benefits schedule (PBS) schedule, so some new drugs aren't available for a short time - as someone else mentioned the government negotiates a fixed price for the drugs. You have to pay for drugs but there's a yearly cap of a few hundred dollars last time I was involved in it and you can claim that back, pensioners have a special low price per drug. There are some drugs that require the doctor to make a case for it - but thats a fairy routine matter. You do hear of people flying overseas for a special treatment (mainly experimental) thats not yet here, that isn't covered. Edit: an example - I had a checkup last year, got a bunch of tests done - total out of pocket for me was $30 or so, all the blood tests are free. The $30 was for the doctor, if I wanted to shop around there are free doctors that just charge the schedule price. I had to get an MRI about 7 years ago, now I could have waited, or got it in the hospital, but I chose to get it at a clinic, cause I wanted to get out of the hospital (which was free) - out of pocket was $800 for that.
- skissane 6y ago
  There are no fixed limits at the individual level. There is a government advisory committee called PBAC which advises the government on whether to pay for certain drugs. There have been cases where PBAC refuses to fund a new drug because it doesn't see the benefit as worth the cost. For example, suppose there is a new cancer drug which costs $100,000 a patient, and on average extends the patient's life by 3 months. PBAC will likely say it isn't worth it for taxpayers to pay $100,000 to extend a person's life only by 3 months. To give another example, in the public health system, there are a certain number of ECMO machines available. Given the limited number, they can't just leave patients on ECMO indefinitely. Sometimes they will take a patient off because the probability of survival is low and there is another patient needing one with a higher probability of survival. But, if you look at patients with low survival probability, most of them will die even with treatment, but a small minority may have nonetheless survived yet now that you are withdrawing treatment they won't. However, we cannot know who will be in that small minority, and society isn't willing to spend unlimited resources on trying to save people's lives against the odds.

But millions per patient is the exception, most people don't have that spent on them, thats why it averages out, and why countries like Australia can afford public health care.

fastball 6y ago

So Australia does not have any caps whatsoever on what they will spend for disease X?

angry_octet 6y ago
We spend far more money on widely prescribed drugs like statins. The most expensive drugs are rarely needed by many people. The big one recently is a drug to treat Hep C, at about A$22000 a patient (but possibly saving years of dialysis) and a macular degeneration treatment (what price do you put in vision?). https://www.abc.net.au/news/health/2020-12-01/australias-most-commonly-prescribed-medicines-statins/12936626 https://www.abc.net.au/news/health/2020-12-01/australias-mos... From someone on the PBSAC: https://www.nps.org.au/australian-prescriber/articles/the-challenge-of-costly-drugs https://www.nps.org.au/australian-prescriber/articles/the-ch... It isn't so much the cost, but whether they actually work, or are any better than other treatments.
chadcmulligan 6y ago
Not that I know of, medications make their way onto the Pharmaceutical Benefits schedule (PBS) schedule, so some new drugs aren't available for a short time - as someone else mentioned the government negotiates a fixed price for the drugs. You have to pay for drugs but there's a yearly cap of a few hundred dollars last time I was involved in it and you can claim that back, pensioners have a special low price per drug. There are some drugs that require the doctor to make a case for it - but thats a fairy routine matter. You do hear of people flying overseas for a special treatment (mainly experimental) thats not yet here, that isn't covered. Edit: an example - I had a checkup last year, got a bunch of tests done - total out of pocket for me was $30 or so, all the blood tests are free. The $30 was for the doctor, if I wanted to shop around there are free doctors that just charge the schedule price. I had to get an MRI about 7 years ago, now I could have waited, or got it in the hospital, but I chose to get it at a clinic, cause I wanted to get out of the hospital (which was free) - out of pocket was $800 for that.
skissane 6y ago
There are no fixed limits at the individual level. There is a government advisory committee called PBAC which advises the government on whether to pay for certain drugs. There have been cases where PBAC refuses to fund a new drug because it doesn't see the benefit as worth the cost. For example, suppose there is a new cancer drug which costs $100,000 a patient, and on average extends the patient's life by 3 months. PBAC will likely say it isn't worth it for taxpayers to pay $100,000 to extend a person's life only by 3 months. To give another example, in the public health system, there are a certain number of ECMO machines available. Given the limited number, they can't just leave patients on ECMO indefinitely. Sometimes they will take a patient off because the probability of survival is low and there is another patient needing one with a higher probability of survival. But, if you look at patients with low survival probability, most of them will die even with treatment, but a small minority may have nonetheless survived yet now that you are withdrawing treatment they won't. However, we cannot know who will be in that small minority, and society isn't willing to spend unlimited resources on trying to save people's lives against the odds.