ADVANCING AFFORDABLE ACCESS TO HEALTH INNOVATION: USING SOCIAL RETURN ON INVESTMENT TO ADDRESS EVIDENCE ASYMMETRY IN AUSTRALIAN FEDERAL BUDGETING
Author(s)
Leonard Lee, MN1, Joshua Byrnes, PhD2, Mark Stewart, Master of Public Policy3, Martin Snoke, PhD4, Hansoo Kim, BSc, MSc, PhD5.
1University of Sydney, Camperdown, Australia, 2Univerisity of Queensland, Brisbane, Australia, 3Roche Products Pty Ltd, Sydney, Australia, 4Roche Products Pty. Ltd, Sydney, Australia, 5Bond University, Robina, Australia.
1University of Sydney, Camperdown, Australia, 2Univerisity of Queensland, Brisbane, Australia, 3Roche Products Pty Ltd, Sydney, Australia, 4Roche Products Pty. Ltd, Sydney, Australia, 5Bond University, Robina, Australia.
OBJECTIVES: To examine how uneven evidence standards across major Australian federal portfolios place a disproportionate burden on Health and Aged Care in funding decisions for health innovation, and to consider how more consistent, wellbeing‑oriented evaluation requirements could support affordable, high‑value care across portfolios.
METHODS: Australian budget documents (Budget Papers No. 1 and 4), central agency guidance, and government portfolio statements were synthesised with conceptual literature on economic evaluation, wellbeing, and SROI to compare evaluation practices across key government portfolios.
RESULTS: In 2025-26, Health and Aged Care (AU70.8 billion), Education (AU72.5 billion), and Defence (AU83.2 billion) operated at comparable fiscal scale, yet only Health explicitly committed to evidence-based policy supported by formal economic appraisal and outcome-based performance. Education and Defence primarily relied on strategic narratives, performance indicators, and statutory oversight with limited transparency regarding formal evidence thresholds for renewal or expansion of major programs. Social Services (AU254.3 billion) and Infrastructure (AU14.8 billion) showed mixed or informal evaluation practices despite large, socially salient commitments in areas such as disability support and housing, all of which influence long‑term health and access to innovation. The ‘Measuring What Matters’ framework, with five wellbeing themes and 50 indicators, signalled an explicit government interest in SROI, but remained largely absent from Expenditure Review Committee funding decisions.
CONCLUSIONS: Health is disproportionately required to meet high evidentiary standards when justifying expenditure, even as demographic ageing and chronic disease increase demand for cost‑effective, high‑value health technologies. To bring greater parity across portfolios in how new programs must demonstrate effectiveness, Social Return on Investment offers a potential bridging framework that can extend more structured, outcome‑focused evaluation expectations to portfolios currently relying on informal or narrative justifications. Health is well placed to pilot SROI, using its mature evaluative systems to demonstrate cross‑portfolio applicability.
METHODS: Australian budget documents (Budget Papers No. 1 and 4), central agency guidance, and government portfolio statements were synthesised with conceptual literature on economic evaluation, wellbeing, and SROI to compare evaluation practices across key government portfolios.
RESULTS: In 2025-26, Health and Aged Care (AU70.8 billion), Education (AU72.5 billion), and Defence (AU83.2 billion) operated at comparable fiscal scale, yet only Health explicitly committed to evidence-based policy supported by formal economic appraisal and outcome-based performance. Education and Defence primarily relied on strategic narratives, performance indicators, and statutory oversight with limited transparency regarding formal evidence thresholds for renewal or expansion of major programs. Social Services (AU254.3 billion) and Infrastructure (AU14.8 billion) showed mixed or informal evaluation practices despite large, socially salient commitments in areas such as disability support and housing, all of which influence long‑term health and access to innovation. The ‘Measuring What Matters’ framework, with five wellbeing themes and 50 indicators, signalled an explicit government interest in SROI, but remained largely absent from Expenditure Review Committee funding decisions.
CONCLUSIONS: Health is disproportionately required to meet high evidentiary standards when justifying expenditure, even as demographic ageing and chronic disease increase demand for cost‑effective, high‑value health technologies. To bring greater parity across portfolios in how new programs must demonstrate effectiveness, Social Return on Investment offers a potential bridging framework that can extend more structured, outcome‑focused evaluation expectations to portfolios currently relying on informal or narrative justifications. Health is well placed to pilot SROI, using its mature evaluative systems to demonstrate cross‑portfolio applicability.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HPR13
Topic
Health Policy & Regulatory
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas