Shortage hits push for blood self-sufficiency
Medibank chief’s call for action on out-of-pocket costs
‘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.