Eli Lilly CEO Seeks New Deal to List Mounjaro on Australia's PBS Amid Pricing Standoff
核心洞察
Eli Lilly CEO David Ricks says the company still wants Mounjaro listed on Australia's Pharmaceutical Benefits Scheme (PBS) despite walking away from a prior deal over pricing.
The company rejected a PBAC recommendation, calling the Australian government's proposed price "significantly lower than any other reimbursed price globally" and "unrealistic and unviable."
Ricks cited an uncapped risk provision requiring Lilly to cover costs beyond a patient eligibility cap as a major obstacle, while noting only two of 13 medicines Lilly launched in eight years are PBS-listed.
Eli Lilly CEO David Ricks says the pharmaceutical giant still wants to reach an agreement with the Australian government to bring its diabetes and weight-loss drug Mounjaro into the Australian Pharmaceutical Benefits Scheme (PBS), despite having previously walked away from a deal over a pricing dispute.
The US-based company had rejected a recommendation from the Pharmaceutical Benefits Advisory Committee (PBAC), saying the "price conditions proposed by the Australian government are unrealistic and unviable." The April decision marked one of several times Eli Lilly has attempted to have the drug added to the PBS, with the company stating the proposed price was "significantly lower than any other reimbursed price globally."
"We definitely want Mounjaro to be listed on the PBS scheme," Ricks told the ABC's 7.30 program. "I think we've attempted that at least three times so far, and it's unusual to not be listed because it's on the WHO essential medicine list."
The Pricing Dispute and Global Ripple Effects
Ricks said price would always be a sticking point, and that lowering the cost for Australia could, in his view, have global consequences. "When we consider the price point, it ripples across the world and can debase the medicine everywhere, which has an effect on our ability to reinvest in R&D," he said. "So we're not interested in access at any price point. We think a fair price point would be good."
He suggested a price similar to that in the UK or Canada, or other countries that have moved forward with listing. Asked how far apart the two sides were, Ricks said he was not personally in the discussion, but "the team reported it wasn't close enough to bridge. And we're struggling to think of a way to resubmit at this point."
The Eligibility Cap and Uncapped Risk
Ricks identified a specific structural obstacle beyond price: the PBS was insisting on a cap on the number of patients eligible for the drug, with Eli Lilly responsible for costs above that cap. "Anything over the cap we would be responsible for even though we don't control the rollout and utilisation, that's just an uncapped risk we can't accept," he said. "So that was a major issue."
He framed Mounjaro's situation as part of a broader pattern. "For us, we've launched 13 new medicines in the last eight years. Only two of them are listed in the PBS. And I think for the industry, only one out of four." He added that Mounjaro is "not the exception. It's the rule that typically new medicines are not listed."
A Question of How Medicines Are Valued
Ricks argued the core issue is how Australia values medicines within its health system. "The overall value of medicines in the total health system has fallen from about 6 per cent of the budget 10 years ago to about 4 per cent now," he said. "So, medicines have been devalued in a way by 50 per cent."
He did not place all blame on the government, however. "We're not [putting] all the blame on the government," he said. "We can be flexible and think about adaptive schemes, and we're open to new schemes, but at the core of it is the value placed on the medicine."
Ricks connected the pricing debate to the funding of future drug discovery, arguing that the success of a drug like Mounjaro "is literally paying for hopefully dozens of medicines that will appear in a decade's time." He posed the question of "what share of that cost should Australians bear so that in 10 years there's another new medicine for maybe brain cancer or Alzheimer's or diabetes like Mounjaro?"
Federal Health Minister Mark Butler said in April that price negotiations were the issue. "There are often very robust price negotiations between big multinational drug companies and the federal government," Butler said. "That tension really and that price negotiation is a very big reason why we have such a successful and sustainable Pharmaceutical Benefits Scheme."
On AI in Drug Discovery and Vaccines
Ricks also addressed artificial intelligence in drug discovery, describing it as "very early" and "early innings." He noted that while language models are built on the entirety of global languages, "we don't have the language of biology written down anywhere," estimating that "between 10 and 15 per cent of all biology is even ever discovered." He cautioned against expecting "incredible cancer cures soon," saying that was "unlikely in the short term."
On the US administration's recent executive order reducing the childhood vaccination schedule from 17 to 11 diseases, Ricks said Eli Lilly is "a science-based company and we believe evidence and proof is how we should make medical decisions." He said he had not read all the details but "would hope that the scientific community kind of raises the question," adding that regarding claims linking vaccination to autism, "we don't have any evidence that that's the case."