In Australia, a new authority category has been proposed to allow prescribing of promising new drugs that have gaps in evidence of clinical effectiveness and that are used only within a randomized clinical trial. Such a method would provide the PBS with good data on effectiveness, cost effectiveness and adverse events occurring postmarketing in the Australian context . Both the pharmaceutical industry and practitioners have commented on the feasibility of such a scheme .
The Australian system differs from the Canadian system in having a federal, centralized PBS. This system has the potential to control drug costs and ensure equity of access to selected pharmaceuticals. It can provide a centralized, well resourced organization to evaluate the comparative efficacy and economics of new Canadian drugs, which may expedite listing and decrease administrative overheads. Uniformity of requirements and a single, national decision allow equity of access to selected drugs across all Australian states.
The Australian advisory committees provide expert advise in technical areas and input from a broad range of clinicians and health professionals. Experts with pharmacological, clinical, epidemiological, economical and statistical skills are consulted. These committees distance politicians and bure-acrats from the decision-making process, at the same time as providing some protection for them. The process is expensive and complex. Due to the secrecy provisions of the National Health Act, the decision-making process is unable to be fully public. As in any committee process, strong opinions may dominate.