Australia ‘boiling the frog’ in medicines policy

20 April 2026

“Day by day, there are fewer medicines coming to Australia for Australians, and that has a downstream effect on clinical trials, on Australia maintaining its status as a first-tier launch country,” says Nic Horridge, Managing Director of Roche Products Australia.

Horridge likens the situation to “boiling a frog” – new medicines are slowly being withheld, clinicians face shrinking options, and clinical trials are drifting elsewhere, but he says policy choices made now will determine the future, and he has a plan to convince the government medicines are worth the investment.

Nic Horridge arrived in Australia two years ago with strong in-country experience across six markets. He has met regularly with Health Minister Mark Butler and Finance Minister Katy Gallagher, working hard to identify what is needed to change Australia’s trajectory in attracting greater investment in new medicines.

That research means Roche is now well down a path developing the evidence it hopes will convince the government medicines are a better investment than other areas competing for its finite budget dollars.

Horridge last week became the tenth company leader to put his name forward for the Medicines Australia Board, optimistic that by using evidence to tell its value story, the sector can still secure a better outcome – but he is also prepared to have a hard conversation about the cost of not investing if his initial strategy fails.

“You have to make it tangible,” he told MedNews. “We need to use data that demonstrates value, and we need to do this by showing that the rate of return of a dollar invested in medicines is significantly higher than, say, a dollar invested in defence.

“We have new innovations coming through where we have way less price flexibility and as an industry, we need to be open to sharing that kind of information and being clear about how this will impact the system.

“Instead of talking about a potential future where we turn into New Zealand, we need to give specific examples of medicines that are not available either because of the system, or the extra focus MFN is bringing.”

Exposing the ‘new world order’ triggered by the Most Favored Nation policy is a shared goal among MA board candidates, but already the challenge of telling this story has been revealed, Pfizer labelled “greedy” for rejecting a low pricing offer. Asked how industry could better tell this story, Horridge says talking about value and acquisition costs “in a clear and succinct way” is key.

“Individual companies telling our story in the press is never going to look good for the big, shiny foreign company seemingly with coffers full of money,” he says. “We as an industry have to come together and be clear about the road we are going down, and the impact that is having.”

The challenge and the opportunity

After years of failing to achieve HTA reform, and with negotiations for the next strategic agreement due to start, most agree the innovative medicines sector needs to take a different approach if it is to both be sustainable and ensure Australians get access to new medicines in a reasonable time.

Horridge is optimistic this is possible, pointing to the UK, Canada and even New Zealand as implementing policy changes that better value medicines, and while he believes taking a positive, collaborative approach is the best path forward, he says industry cannot shy away from having a hard conversation if the government fails to listen.

He believes Health Minister Mark Butler is aware of the cost of doing nothing but needs help convincing his Cabinet colleagues greater investment in medicines will pay dividends – and Roche is hoping to provide that evidence.

“It’s very easy to talk about the cost of medicines because they’re a single price line,” says Horridge. “If we think about the strategic agreement, at face value I don’t think there’s a lot in it for us to be honest. It is really a cost management model for the department where we say what size slice of the pizza we want and what we are willing to pay for it.

‘Not the time to go backwards’

Horridge’s view that the industry needs to speak not just about health policy but finance and productivity will likely sit well with his MA colleagues, many horrified that the NDIS continues to grow at eight per cent while net investment in the PBS declines.

Pointing to Australia’s ageing population and falling productivity, Horridge says, “This is not the time to go backwards”.

“At the end of the day, the government represents the taxpayer and wants to get the best value for the taxpayer,” he explains. “Our job is to demonstrate the value we bring and to do that, we have to use better evidence so that the decision can be made rationally rather than simply as a cost containment measure.

“Simultaneously, we have to be very clear and very public about the cost of going down the path we are on. Over the past 18 months or so, I’ve seen a willingness in MA to be more forthright and clear, if you will, on those negative arguments and less concerned about reputation or being friends with everybody as perhaps we were in the past.”

There is undoubtedly a groundswell of unrest across MA members. BMS Managing Director and MA Board Director Owen Smith said last year HTA reform “needs to be written in black and white” in the 2026-27 Budget, and while that is now highly unlikely, Horridge agrees the innovative medicines sector has reached a critical juncture.

“There’s this feeling now, this groundswell across MA that this is the time, the moment of truth, our hill to die on, or whatever cliché you choose,” says Horridge.

“I share that view, and the board has to represent the majority. I believe that’s where we’re heading, but I still want to lead with the benefits we bring and then talk about the consequences of inaction.

“If I’m fortunate enough to be elected, I will be representing the industry as a whole and my belief is that a rising tide floats all boats. We can fight our product battles individually, but fundamentally, we have to agree on our approach. If the next strategic agreement ends up being similar or worse, now is the time to stand up and be counted.”

While the local sector is traditionally hesitant to elect foreign directors, Horridge’s New Zealand nationality will be seen as a positive, as it was for his predecessor Stuart Knight who served two terms on the MA Board. Horridge was in Korea for five years and hopes he will be in Australia for another three, his teenage daughter determined to finish high school here. Horridge also has his own reasons for wanting to stay.

“I want to see us deliver HTA reform that is valuable to us,” he says. “We talk a lot about strategic agreements but over the longer term, HTA reform is the Holy Grail we all want to see delivered in the way we envisaged.”

©MedNews 2026