Australia’s nuclear medicine sector is urging the Commonwealth to establish a dedicated national funding stream for radiopharmaceutical cancer therapies, warning that the current patchwork of reimbursement arrangements is leaving public hospitals financially exposed and delaying patient access to life-extending treatments.
In a submission to the government ahead of the 2026–27 Budget, Nuclear Medicines Australia (NMA) has called for the creation of a Radiopharmaceuticals Benefits Scheme (RPBS). It would be a standalone national reimbursement framework that sits alongside, but outside, existing funding mechanisms such as the PBS, the Medicare Benefits Schedule, and hospital budgets.
The proposal reflects growing concern that Australia’s health financing architecture has failed to keep pace with the rapid emergence of high-cost therapeutic radiopharmaceuticals, particularly in oncology. At present, funding is fragmented across multiple streams, with medicine costs, professional services and hospital delivery absorbed in different parts of the system. According to NMA, bundled Medicare payments have not kept up with the true cost of delivering complex nuclear medicine therapies, forcing some centres to limit or suspend services.
The strain has been most visible in therapies such as lutetium-177 PSMA for advanced prostate cancer, where hospitals have reported operating 'out of pocket' as demand increases. NMA argues that without structural reform, access inequities will widen as more radiopharmaceuticals enter clinical practice.
Beyond funding fragmentation, the submission also highlights what it describes as lengthy, sequential market-access pathways, with cancer patients waiting between 18 and 36 months from regulatory approval for publicly funded access. To address this, NMA is proposing a radiopharmaceutical-specific health technology assessment process that would allow parallel assessment by the Therapeutic Goods Administration and reimbursement bodies, with the goal of funding decisions being made within months of registration rather than years.
Under the proposed RPBS model, the cost of radiopharmaceutical therapies themselves would be funded at nationally negotiated prices, while associated professional services, including imaging, diagnostic agents, radiopharmaceutical preparation, administration and follow-up, would continue to be reimbursed through indexed Medicare items and rebates. Oversight of the scheme would sit with a dedicated advisory committee drawing on expertise from existing PBAC and MSAC processes, supplemented by nuclear medicine and oncology specialists.
To manage uncertainty and budget impact, the scheme would rely on managed-entry and value-based arrangements such as discounts, expenditure caps and outcomes-linked rebates.
NMA recommends a staged rollout, beginning with one or two pathfinder therapies —such as lutetium-177 PSMA for metastatic castration-resistant prostate cancer and lutetium-177 DOTATATE for eligible neuroendocrine tumours, before expanding over three to five years to additional indications, including emerging alpha-emitting therapies.
Indicative Commonwealth expenditure under the model is forecast at $30–50 million in the first year, rising to approximately $180–250 million annually as the scheme matures. NMA argues that even at projected 2030 spending levels, the RPBS would account for a minimal fraction of PBS outlays, and that costs would be partially offset by reduced use of late-line chemotherapy, fewer hospital admissions and improved quality-adjusted survival outcomes.
The submission has been endorsed by a range of industry and clinical leaders, including the Nuclear Medicines Australia board, Simone Leyden AM of Telix Pharmaceuticals, Cody Allison of OncoBeta Australia, Jason Beirne of Global Medical Solutions Australia and Jacquie Cawthray of Cyclowest.