Debate+Topic+1

=Debate Topic 1=

//Viagra® (sildenafil) should be subsidised on the Pharmaceutical Benefits Scheme for erectile dysfunction.//

Background
The PBS was introduced in the 1950s to make sure that all Australians had access to the (then) new class of life-saving drugs called antibiotics.

Not all drugs are on the PBS. If a drug isn't on the PBS, you pay the full price. A drug may not be in the PBS because the government has decided it doesn't offer any advantage over similar drugs already on the PBS. Or it may be considered non-essential – Viagra, for example, is not on the PBS for general use.

The federal government through the PBS has enormous power to determine drug prices. If a drug is considered too expensive, it won't go on the scheme; if it's not on the scheme, sales of the drug are very low (as doctors tend not to prescribe it). Hence it's an incentive for drug companies to keep prices low – Australian drug prices are much lower than the OECD average.

Why it should be subsidised
- affects 1 million men (significant enough to warrant subsidy?) which will increase due to increase in diabetes - it is product that is apparently equally effective to the injectable form that's currently listed, that it is apparently safer and of similar cost (PBAC has to compare it with existing therapies, in terms of efficacy, toxicity and cost) - 10 disease states have been defined where erectile dysfunction is a secondary outcome - subsidising will lead to more people being able to alleviate symptoms of their condition -** lowering the price leads to more people treating their condition, less worry/depression and generating more productivity through work and friendship etc. - not lowering the price leads to less erectile dysfunction being treated, a condition that can develop depression that can affect many people concerning the person, as well as their job etc. - people have a right to access medicines that will treat their condition
 * Beneficence:**
 * Consequentialism:
 * Rights:**

Why it shouldn't be subsidised
- it is considered as a non-essential medication (compared with the lipid-lowering drugs, that reduce mortality directly) - doctors may prescribe the subsidised drug to people even though they don't quite fit the guidelines (doctors could come under pressure to break prescription guidelines) - would be very expensive to subsidise (plus it will have a much higher uptake and the total cost to Government will increase further) - There is potential for it to be abused as there is no pathognomic sign. So patients who do not fit the criteria may be recieving it a a subsidised cost. - We currently have a number of options for treating the underlying causes of erectile dysfunction which may be benificial in preventing the condition. - not subsidising will save the Government more money, which could be spent in other areas that could benefit a majority of people - money spent on subsidising Viagra means less money spent on other areas, including subsidising other medicines that may be more directly linked to reducing mortality - people have a right to not pay for something that they do not use
 * Beneficence:**
 * Consequentialism:**
 * Rights:**

Resources
[|Erectile Dysfunction Factsheet]: looks at what this condition is and how it can be treated [|Debate over subsidising Viagra]: a transcript of a 7:30 Report interview, including Professor Lloyd Sansom [|Saving money on medicines]: a general background on generic medicines and the PBS (PS with this last article: - the prices are last yrs. This yrs are $5 and $31.30 rather than the $4.90 and $30.70 stated in the Article)