Short­age hits push for blood self-suf­fi­ciency

Med­ibank chief’s call for action on out-of-pocket costs

The Weekend Australian - - THE NATION - SEAN PAR­NELL SARAH-JANE TASKER BUSI­NESS

‘It’s sad that peo­ple are be­ing bankrupted be­cause of med­i­cal costs’ CRAIG DRUM­MOND MED­IBANK CHIEF

Most sup­plies of a blood prod­uct that is vi­tal to the nation’s health sys­tem — and to pa­tient sur­vival — may soon be im­ported, un­der­min­ing Aus­tralia’s long-held pol­icy of self-suf­fi­ciency.

The Na­tional Blood Au­thor­ity has con­firmed 44 per cent of all im­munoglob­u­lin (Ig) used in 2016-17 had to be bought from over­seas sup­pli­ers. With de­mand for Ig ris­ing at 11 per cent a year, but lo­cal blood plasma col­lec­tions needed to man­u­fac­ture Ig ris­ing only by 5 per cent, imports are likely to make up the ma­jor­ity of prod­ucts used within months.

Ig is used in dif­fer­ent forms to treat a range of con­di­tions where im­mune re­place­ment or im­mune mod­u­la­tion ther­apy is re­quired, and also in cases of se­vere blood loss. Sourc­ing and sup­ply­ing such plasma prod­ucts now takes up half of the NBA’s $1 bil­lion-plus gov­ern­ment-funded bud­get, with costs in­creas­ing from $205.2 mil­lion to $504.6m over the past 14 years.

Fed­eral, state and ter­ri­tory gov­ern­ments have long agreed to “pro­mote self-suf­fi­ciency” through the NBA and the Aus­tralian Red Cross Blood Ser­vice that col­lects blood and plasma lo­cally, but that has be­come more of an as­pi­ra­tion than a re­quire­ment in re­cent years as Ig has trans­formed health prac­tices and mar­kets around the world.

The NBA has taken out im­port con­tracts, which ex­pire in 2019, with Bax­alta Aus­tralia (also known as Bax­ter), CSL Behring Aus­tralia, Novo Nordisk Phar­ma­ceu­ti­cals and Pfizer Aus­tralia. Bax­ter had pre­vi­ously sought ac­cess, without suc­cess, to CSL’s exclusive Med­ibank chief Craig Drum­mond says the is­sue of ris­ing out-of-pocket med­i­cal costs must be ad­dressed, call­ing on the Turn­bull gov­ern­ment to act quickly.

He said con­sumers were rightly ask­ing for higher lev­els con­tract to process Aus­tralian donor plasma, even seek­ing spe­cial deals in trade ne­go­ti­a­tions be­tween Aus­tralia and the US. Last year, it made $31.45m ship­ping plasma prod­ucts to Aus­tralia — of ac­count­abil­ity and dis­clo­sure. “Any party, whether pri­vate health in­sur­ers or health­care providers, would be un­wise to push back strongly against this push (for trans­parency) from con­sumers,” he said.

Health Min­is­ter Greg Hunt has ap­pointed chief med­i­cal of­fi­cer Bren­dan Mur­phy to chair a com­mit­tee to in­ves­ti­gate outof-pocket ex­penses and en­sure con­sumers are bet­ter in­formed of fees be­fore agree­ing to treat­ment. The an­nounce­ment was fol­lowed by news that Aus­tralians were in­creas­ingly ac­cess­ing su­per­an­nu­a­tion early about one 10th of what the for­merly gov­ern­ment-owned CSL made from the NBA.

Last month, the NBA, on be­half of gov­ern­ments, signed a new, nine-year con­tract with CSL, to pay for med­i­cal bills.

It has also been re­vealed that “ill health or the lack of in­sur­ance” was the pri­mary cause of non-busi­ness-re­lated per­sonal in­sol­vency for 1830 peo­ple in 2016-17. which fed­eral Health Min­is­ter Greg Hunt de­clared to be a lo­cal suc­cess story. “The sign­ing of this new agree­ment with CSL Behring sig­ni­fies our com­mit­ment to en­sur­ing the safe and se­cure sup­ply

“It’s sad that peo­ple are be­ing bankrupted be­cause of med­i­cal costs. I feel for peo­ple go­ing into these sit­u­a­tions without full trans­parency,” Mr Drum­mond said, adding that while he would not pre­sup­pose what the gov­ern­ment com­mit­tee would de­liver on, the cur­rent sys­tem was not good enough.

“I’m not go­ing to point the fin­ger at any one group; it’s for all of us, in­clud­ing pri­vate health in­sur­ers, to get our act to­gether to pro­vide trans­parency about what the out­come (for pa­tients) is likely to be,” he said.

“Let’s hope the com­mit­tee of life­sav­ing and life-im­prov­ing blood prod­ucts for peo­ple who need these plasma-de­rived ther­a­pies, de­liv­ered through lo­cal man­u­fac­tur­ing and lo­cal in­no­va­tion,” he said at the time. works with speed and doesn’t get locked up in com­mit­tees that take years to come to fruition.”

Yet Aus­tralians could be in line for some re­lief on costs, with this year’s in­sur­ance pre­mium in­creases widely ex­pected to be lower than last year’s.

Mr Drum­mond said Mr Hunt had said he would like a fig­ure of about 4 per cent, or just be­low. The in­dus­try av­er­age last year of 4.84 per cent was a decade low.

“There is a lot of scru­tiny, as there should be, on this num­ber,” Mr Drum­mond said. P23

In the ARCBS an­nual re­port, chair­man Jim Birch and chief ex­ec­u­tive Shelly Park ac­knowl­edged the “on­go­ing chal­lenge in the un­abated rise in de­mand for plasma”, which has co­in­cided with a drop in de­mand for red blood cells.

Last year, the amount of plasma col­lected for CSL in­creased from 601 tonnes to 637 tonnes, from al­most 150,000 lo­cal donors but that still did not keep up with de­mand.

The ARCBS re­cently opened a plasma-fo­cused donor cen­tre in Townsville and will open an­other in Can­berra, as it looks at ways to en­cour­age more peo­ple to do­nate more plasma more fre­quently.

Its 2017-19 busi­ness plan em­pha­sises the im­por­tance of se­cur­ing and im­prov­ing lo­cal sup­plies, declar­ing “the need for healthy plasma donors is greater than at any other time in our his­tory”.

The ARCBS and the NBA have also been work­ing to im­prove ef­fi­ciency through new tech­nol­ogy that bet­ter uses do­na­tions to new guide­lines for health prac­ti­tion­ers on the ap­pro­pri­ate use of Ig.

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