What alternatives are there to FP 50?

Matt Woodley

24/05/2023 4:18:40 PM

With the common asthma medication not expected to return to the PBS until July, GPs may need to give patients other options.

GP listening to child's breathing.
Restrictions on initiating fluticasone propionate 50 mcg prescriptions are unlikely to be lifted until sometime in July.

A consortium of asthma organisations has compiled new information aimed at helping GPs navigate recently applied restrictions on initiating fluticasone propionate 50 mcg (FP 50) prescriptions.
While the restrictions have since been flagged for reversal following concerted advocacy from the RACGP and other medical groups, that process is unlikely to happen until sometime in July.
In the meantime, Asthma Australia, in conjunction with the National Asthma Council and the Thoracic Society, have put together a fact sheet GPs can refer to when considering their prescribing options.
According to the fact sheet, which was reviewed by RACGP Specific Interests Respiratory Medicine Chair Dr Kerry Hancock and Australian Asthma Handbook Guidelines Committee member Dr Brett Montgomery, children aged six years and older for whom an inhaled corticosteroid (ICS) is indicated can be switched to an alternative PBS reimbursed medicine, specifically: 

  • beclometasone 50 mcg, twice daily
  • ciclesonide 80 mcg, once per day
  • budesonide 100 mcg, twice daily.
If children are switched to an alternative ICS from FP 50, the group recommends completing a clinical review in 4–8 weeks, as switching inhaled preventer medicine, even within class, can sometimes result in changed asthma control.
Meanwhile, for patients aged six and under, the group says the options are ‘limited’, and as such they recommend a private prescription or rapid access and assessment by a paediatrician or respiratory specialist.
However, if those options are not possible, the group states children aged 5–6 can be prescribed beclometasone 50 mcg. Repeats on current prescriptions dated before 1 April 2023 can also still be used.
In addition to the fact sheet for prescribers, the group has also developed information for patients related to the current restrictions, and is providing advice via 1800 ASTHMA.
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