Come on, come on, give me something for the pain
Love can free us from the pain of life, Sophocles argued. But people like Raylee and John would disagree.
John painted houses until his back gave way. Facing $12,000 health bills even on private health insurance, Raylee wrote to me about her husband in despair. No one wants to be dosed up on everything the pharmaceutical the world can offer. John has no choice; the relentless and gnawing neuropathic pain now consumes a third of his Workcover payment.
Nearly one in three Australians live with some form of chronic pain with just 20 per cent of these satisfied with their pain management. Along the spectrum of pain, the worst of the worst is neuropathic pain. It has driven some to suicide, yet there is not a single drug specifically designed to treat this kind of pain funded on the PBS. It’s pain from a limb which is no longer there. It’s the pain after shingles where even a zephyr of wind or the brush of a garment can elicit electric shocks. No pain is nastier than when one’s neurological system turns on itself.
For decades, there has only been narcotic analgesia for these patients. Being narcosed for life isn’t pleasant. But finally there is Lyrica. According to pain experts it is the Holy Grail, a drug which can rescue pain sufferers from the brink and get them off narcotics.
Deemed safe and effective by our TGA, Lyrica’s next stop was with the Pharmaceutical Benefits Advisory Committee (PBAC). As Australia’s drug referee, the PBAC removes the politics by mediating the complex price and access negotiations between drug firms and government.
But at this point, it was our federal government who walked off the field to sulk in the change room. Only ‘life-saving’ drugs will be approved. That condemns people like Raylee and John to a lifetime of finding up to $500 a month for Lyrica.
Leading pain expert Michael Cousins views the rejection of Lyrica as a human rights violation which forces people to live in pain all the while it is available and declared to be safe and cost effective.
Lyrica’s planned cost of $30 million annually is just a fraction of the overall $34.3 billion annual cost to the economy from the effects of chronic pain – a $1133 return per dollar Treasury’s bean-counters could only dream about.
The point where the economic pain of government trumps the neuropathic pain John lives with, depends on your point of view. Unlike his pain, this government’s debt position is entirely self-induced.
Australia led the world with its PBAC, which kept politicians out of new drug approvals. If drug benefit per dollar stacked up, new drugs were approved. That provided certainly to pharmaceutical companies. Make the grade and you will get a return, free of molestation from governments which can’t run their books. Now the government is simply saying, we know better than the health experts do.
The Health Minister calls delays like Lyrica a deferral. But a deferral without an end date is really a rejection. Rejecting drugs for battlers like John didn’t used to be the Labor way. But eventually too many promises, too much free money and too much waste means the party is over for the Green/Labor coalition expert in spending but not saving.
Denying Australia Lyrica, when ever other developed nation provides it for its citizens is totally unjustifiable. Australia was once a nation that pioneered funding treatments that embodied the fair-go for those suffering pain. Despite having the best economy in the OECD, its every other nation that has found a way to afford Lyrica.
Ditching the PBAC process is disappointing. Previous administrations used to take the really big decisions to Cabinet, but even that has been dumped. ‘Need not even apply’ is the sign on the Health Minister’s door for little reason other than they spent too much on pink batts and school halls and now the cupboard is bare.
Denying Australians Lyrica is hitting people in every community around the nation; those with diabetic and cancer-related neuropathy, spinal cord injury, multiple sclerosis, limb amputation and pain following shingles, traumatic neuralgia, or stroke.
None of us would want to see Australians living with avoidable pain, while a treatment is both available and approved. But the Gillard government seems more intent treating its own economic pain than it is serving Australians who are living with the real thing.
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