The emerging impact of China's use of international reference pricing might pose a significant risk to access to medicines in Australia. The critical importance of detail and getting the basics right when negotiating with the government - its ability to operate so effectively in the detail is how the government succeeds in these negotiations. Phrase of the week!

Why long-term thinking and planning are the key to success. What is the ten-year goal, and how does a new agreement progress that? Plan for policy and government engagement like it's a product launch. Also, is the problem with the HTA Review the process or the expectation? How a different starting point would have made this outcome positive.

Where did these industry agreements come from, and why? In the first episode of a two-part special, we discuss the genesis of the Australian government's agreements with the industry, based on personal experience, why they emerged as a solution to a decade-old challenge, and the problem they were aiming to solve. The opportunities, the risks, the vulnerabilities, and the importance of understanding how we arrived here.

Powerful patient stories stand in contrast to a decision-making framework that explicitly dehumanises their lived experience. The need for 'decency and compassion'. Week one of Senate Estimates, the challenge of saying one thing publicly and something else privately, and a Budget that revealed so much about what is coming.

There are enough measures and signals in this week's Budget to suggest medicines, vaccines and other technologies were discussed extensively in the process leading up to Tuesday's announcement. It might also help explain Health Minister Mark Butler's annoyance at one organisation's response. A Government response to a parliamentary inquiry triggered another odd response from stakeholder groups.

In this week's episode, the focus is on the latest example of no progress on reform, the mindset and intransigence it reveals, the repeated pattern, and the early evidence that it would always end this way. Can it be an opportunity? Next week's Budget is upon us, and the discussion focuses on what to look for, that just because it is not in there, does not mean it is not in there, and why gaining any cut-through will be a real challenge.

In this special episode, the focus is on the official plan to force a 'consensus' on health technology assessment reforms through a process conducted in secrecy under the guise of ethics approval. The problem with running this policy process like a clinical trial is that we do not and will not know the identities of participants, how they were selected, their input, how it is used and weighted, or even the study protocol.

Tokenistic characterisations of patient engagement are no substitute for listening and empowering. The risk of government funding for organisations and how it can impact what they do, primarily because the government is just another vested interest.