PBAC to review FP 50 decision

Matt Woodley

4/05/2023 4:47:56 PM

Controls placed on GPs initiating PBS prescriptions of the commonly used paediatric asthma medicine will be revisited at the next intracycle meeting.

Child using asthma puffer
Fluticasone propionate 50 mcg has been prescribed more than 1.45 million times since being listed on the PBS in 2001.

The Pharmaceutical Benefits Advisory Committee (PBAC) will review the restrictions placed on GP-initiated PBS prescriptions of fluticasone propionate 50 mcg (FP 50), the agenda for its Friday 5 May intracycle meeting has confirmed. 
Last month’s changes to the PBS listing, first reported by newsGP, mean patients aged under six now need to be referred to a paediatrician or respiratory physician in order to start receiving the medication via the PBS, while those six years and older cannot access a PBS subsidy for FP 50 at all.
The decision drew outcry from various medical groups, including the RACGP and National Asthma Council of Australia, who warned young children from vulnerable backgrounds would be most impacted, due to cost and access issues associated with specialist appointments.
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, wrote to the Federal Government in an effort to reverse the decision and told newsGP she is optimistic of getting a positive result.
‘We … truly hope that the PBAC will fully overturn their previous short-sighted decision in at least the under-six-year-old cohort, where there is no alternative ICS [inhaled corticosteroid] medication available on the PBS,’ she said.
‘Otherwise, it is children and families from vulnerable communities who will be extremely compromised, either by the increased cost of their medication on a private prescription, or the need to access a paediatrician.
‘We all know how difficult – and expensive – that can be.’
The PBAC is yet to provide a justification behind its original decision, while the Department of Health and Aged Care also declined to provide the rationale when approached by newsGP.
FP 50 has been prescribed more than 1.45 million times since being listed on the PBS in 2001, including on nearly 86,000 occasions last year alone.
Dr Hancock estimates 60% of those prescriptions would have been initiated by a GP and believes the other PBAC decision to stop subsidising the medication for any patient over six years should similarly be scrapped.
However, according to the PBAC meeting agenda, the committee is only scheduled to review the General Schedule Authority Required listing for patients under six years.
‘The alternative is that GPs managing those children, in whom it is appropriate to be on ICS therapy, will need to write a private prescription for FP 50 or be prepared to change the inhaled steroid treatment to other formulations of equivalent potency – and an age appropriate device,’ Dr Hancock said.
PBS statistics show that the Government only subsidised $1.2 million worth of scripts last year, so cost shouldn’t really be an issue I wouldn’t have thought.’
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A.Prof Christopher David Hogan   5/05/2023 4:50:18 PM

An excellent idea.
I was part of Asthma Australia, National Asthma Council & Australian Lung Foundation & helped write a range of protocols including those for paediatric asthma.
I can therefore guarantee that it is well within a GP skill set to effectively diagnose & treat asthma.

Dr David Robert Talon Jones   7/05/2023 2:23:53 AM

Please - Please can somebody explain to me how on earth this is decision was even conceived let alone implemented? It just beggars belief on so many levels.

I can only think that they are hoping to curb inappropriate early diagnoses of asthma?

Anybody have any other ideas?

Dr Julia Ann Conway   8/05/2023 4:10:14 PM

With such a large number of junior doctors choosing specialties over General Practice this type of thing will become inevitable. Just like the debacle over the medicare rebate for ECGs. Turkeys don't vote for Christmas.