Do children get priority in Australia's drug funding decisions?

CHE RESEARCH BITES

By Jing Jing Li, Duncan Mortimer, Anthony Harris, Emily Lancsar, Rakhee Raghunandan, Kah-Ling Sia, Nicola Huxley, Leonie Picton, Nayyereh Ayati, Karen Yong, Stavros Petrou, Martin Howell, Marcus Sellars, Elisabeth Huynh, Cam Donaldson, Kirsten Howard, Dennis Petrie and Gang Chen

20 February, 2026

In Australia, the Pharmaceutical Benefits Advisory Committee (PBAC) recommends which medicines should be subsidised through the Pharmaceutical Benefits Schedule (PBS). When making these decisions, the PBAC considers many factors, including clinical evidence, cost-effectiveness, and broader social values.  Age is listed as one of the “less-readily quantifiable factors” that may influence decisions, but it has never been clear whether children’s treatments are actually given priority.

This study examined almost 20 years of PBAC decisions (2005-2023), covering more than 1,400 funding applications from pharmaceutical companies seeking public subsidy for their medicines. For each submission, the researchers analysed the committee's decision and key features of the evidence: how well the medicine works, its costs relative to its benefits, and how certain the committee was about the results.

After accounting for all of these factors, the study found a clear pattern: medicines intended for children were significantly more likely to be recommended for government funding than medicines for adults, even when their costs, even when their costs and benefits were similar. A treatment specifically for children was 16 percentage points more likely to be recommended for subsidy.

Importantly, this advantage held up even after the researchers accounted for other reasons a children's drug might be viewed favourably — for instance, that it might treat a rare or very serious condition, or that it might be a vaccine.

This matters because the PBAC does not formally apply a higher value to health gains in children. Yet the pattern in real‑world decisions suggests that, in practice, the committee has been giving extra weight to children’s health for many years. This aligns with public preference studies showing that Australians — and people in many other countries — tend to prioritise improving children’s health more highly than adults’.

This is the first study to demonstrate this using actual funding decisions rather than survey responses. It provides new and timely evidence for policymakers who are considering whether, and how, age should be formally incorporated into Australia’s drug funding framework.

Li JJ, Mortimer D, Harris A, Lancsar E, Raghunandan R, Sia KL, Huxley N, Picton L, Ayati N, Yong K, Petrou S. Social value of a Childhood QALY-Revealed preferences from pharmaceutical funding decisions in Australia 2005–2023. Social Science & Medicine. 2026 Feb 9:119080.

Find out more about the Economic Behaviour, Incentives and Preferences in Health and Economic Modelling of Health Policies and Technologies themes.

CHE Research Bites are short, easy-to-understand summaries of our recent academic papers highlighting new evidence and insights on topical issues in the health and healthcare sectors.

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