Keep it simple: one prescription, one pathway
October 2025
Keep it simple: one prescription, one pathway
Radioligand therapy (RLT) is no longer on the horizon. It has arrived in Australian clinics, offering a powerful new way to treat cancers that previously had limited options. This breakthrough therapy has the potential to transform outcomes for Australian patients and as outlined in our Bench to Bedside: The Promise of Radioligand Therapy report, it also presents a major opportunity for future investment. But while the therapy has arrived, the question remains:
How do we ensure patients can access RLT once it is approved?
In Australia today, there are only two national reimbursement pathways available for RLT: the Pharmaceutical Benefits Scheme (PBS) and the Medicare Benefits Schedule (PBS). The PBS is well designed to provide access to innovative medicines that need close clinical oversight. For patients and providers, access is relatively straightforward, once the medicine is listed on the PBS. It is predictable, equitable and relatively straightforward. The MBS, by contrast, has long been used to fund services such as imaging, pathology, surgery and specialist consultations. It was never built with innovative, highly specialised treatments like RLT in mind.
In July 2025 an MBS item was introduced for the administration of RLT for advanced prostate cancer patients. At first glance this appeared to be progress. In practice it has created a pathway that does not fit the therapy and makes it difficult for clinicians and their patients to access and afford. The item does not cover the full cost of service, leaving patients facing significant out-of-pocket expenses, if they are able to navigate access at all.
To highlight these challenges, we have illustrated the stark difference in complexity between accessing innovative therapies through the PBS and through the MBS.
Ultimately, RLT therapy highlights the challenges that arise when innovative treatments are accessed through pathways that are not designed for them. Patients face unpredictable costs, providers navigate complex billing rules, and access can vary depending on setting and location. By comparison, the PBS offers a clearer and more consistent model.
The takeaway is straightforward: to support access to future innovations, Australia needs approaches that aim to keep it simple — one prescription, one pathway.
Renae Beardmore
Managing Director, Evohealth
Deanna
Mill
Advisor, Evohealth
