Expanded PBS listing for empagliflozin

More Australian patients will have access to empagliflozin (sold as Jardiance) through the Pharmaceutical Benefits Scheme (PBS) after its listing has been expanded.
 
From 1 April, the changes brought empagliflozin into line with earlier PBS expanded criteria for other sodium–glucose cotransporter 2 (SGLT-2) inhibitors, including dapagliflozin.
 
Removing the need for a specific unmet glycaemic target, the revised PBS criteria will enable more patients to benefit through improved glycaemic control and cardioprotective properties.
 
Specifically, the expansion allows ‘treatment in combination with metformin (unless contraindicated/intolerant) with no glycaemic requirements for patients with type 2 diabetes mellitus and high cardiovascular risk’.
 
‘This includes patients with cardiovascular disease, those at high risk of a cardiovascular event, and Aboriginal or Torres Strait Islander patients,’ the PBS announcement said.
 
Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, described the changes as a ‘double win’.
 
‘This allows for improved clinical access for people with type 2 diabetes to evidence-based cardiovascular risk reduction therapy whilst also providing glucose management,’ he told newsGP.
 
‘Also, it facilitates earlier intervention by removing glucose target hurdles that existed before being able to prescribe.’
 
Dr Deed said GPs can take this opportunity to review their cohort of patients with type 2 diabetes and to perform a heart risk assessment and a medication review.
 
Director of the Diabetes Centre at Royal Prince Alfred Hospital, Dr Ted Wu, highlighted the importance of preventing cardiovascular disease in people with type 2 diabetes.
 
‘With type 2 diabetes, it’s no longer enough to simply treat to HbA1c target. We need to look at a patient’s full health profile and address risk factors across the cardio-renal-metabolic system,’ he said.
 
‘The good news is that we can now provide the same level of cardiovascular protection to patients with good glycaemic control as we have done for those with higher glucose levels.
 
‘There is strong evidence to intervene early in the trajectory of patients with type 2 diabetes and cardiovascular risk factors. There is no reason to wait until they reach an HbA1c level greater than 7%.’
 
Dr Deed also highlighted the importance of a holistic approach in diabetes management, as outlined in the RACGP’s ‘Management of type 2 diabetes: A handbook for general practice’.
 
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