The Royal Australian College of GPs (RACGP) has welcomed the Pharmaceutical Benefits Advisory Committee’s (PBAC) decision to remove limitations requiring non-GP specialist prescribing of several asthma medications.
It comes following the RACGP writing to the PBAC Chair Professor Andrew Wilson querying the reasoning behind the original move to place new restrictions on 50mcg Axotide Junior and Flixotide Junior (fluticasone propionate) so that the drugs could only initially be prescribed by a respiratory specialist with authority approval by Medicare.
RACGP President Dr Nicole Higgins welcomed PBAC’s reversal.
“This is a win for Australian families at a time of high cost of living pressures,” she said.
“Following our advocacy and calls from health professionals and other professional groups, the Minister for Health and Aged Care Mark Butler wrote to PBAC respectfully asking them to review their decision. Thankfully, they have reversed course and reviewed the initial recommendations so now patients will once again be able to receive a prescription for these drugs from their regular GP. This is a great result for patient care, and I applaud Minister Butler for raising this with PBAC and making it a priority.”
Dr Higgins said it was a sensible move that would save families time and money.
“The original changes were bad news in terms of equity of access, particularly since fluticasone propionate is the mainstay of asthma management for children and teenagers,” she said.
“Before the Committee reversed their decision, GPs and patients had to jump through several hoops and make some difficult decisions. It was particularly disadvantageous to rural and regional patients who struggle to access non-GP specialist care at the best of times. When a GP decided that a child with asthma between one and five years should start on inhaled corticosteroids, the GP had to either refer to a paediatrician or respiratory physician; prescribe the drug on a private script; or prescribe other medicines ‘off label’ which often involved higher-dose steroids.
“So, at the end of the day the patient’s family were paying more. Inability to access pharmaceutical benefits scheme subsidies and the cost of the script being ineligible in counting towards the safety net put them at a real disadvantage at a time of high cost of living pressures. The family basically had to choose between incurring paediatrician or respiratory physician appointment fees, or the $11 to 28 cost per inhaler of a private script.
“There were also additional costs to the broader health system in terms of unnecessary consultations with paediatric respiratory physicians and paediatricians. The RACGP is unaware of any inappropriate prescribing of fluticasone propionate in young children, so the clinical need for this change was always unclear and that is why we pushed back so strongly against it.
“Let’s use this as a learning experience. The RACGP was not aware of any open consultation on this issue before the changes were announced by PBAC, so in future it’s important to listen to all voices on such important decisions and that includes GPs and practice teams.”