The Pharmaceutical Benefits Scheme (PBS) review of medications for endometriosis, spearheaded by the Pharmaceutical Benefits Advisory Committee (PBAC) in December 2022, has cast a significant spotlight on the healthcare needs-of individuals grappling with endometriosis and associated conditions across Australia. This comprehensive stocktake embarked on a mission to meticulously identify the gaps between medicines funded by the PBS and those available to patients at their full cost, setting the stage for potentially expanding access to essential treatments.
The review underscores a critical healthcare issue, highlighting the urgent need for more inclusive and accessible treatment options for those affected by this debilitating condition. By examining the discrepancies in medication accessibility, the PBAC aims to facilitate a more equitable healthcare landscape, where effective treatments are within reach for all individuals in need.
The initiative reflects a broader commitment to enhancing patient care and support for Australians living with this health issue, a condition that significantly impacts their quality of life. It opens a dialogue between stakeholders, healthcare providers, and the government, fostering collaboration towards improved treatment availability and affordability. Through this stocktake, the PBAC not only seeks to address current limitations but also to anticipate future healthcare needs, ensuring that the PBS continues to evolve in response to the changing landscape of endometriosis treatment.
Boosting Support for Endometriosis in Australia: Government Allocates $58 Million for Treatment and Research
Endometriosis is a prevalent condition where tissue similar to the womb’s lining grows elsewhere in the body, often leading to pain, heavy menstrual bleeding, and fertility issues. Affecting over 11% of Australian women, girls, and gender-diverse individuals, endometriosis starts typically in the teenage years and currently has no cure. The stocktake underscores the necessity for more accessible PBS-funded medicines to manage this debilitating condition, given that the available treatments are sometimes ineffective, poorly tolerated, or carry a risk of addiction.
The Australian Government, recognizing the significant burden of endometriosis, has allocated $58 million in the 2022-23 Budget for its treatment and related pelvic pain. This funding is part of the broader National Action Plan for Endometriosis (NAPE), which includes the establishment of specialized clinics, funding for research, development of treatment guidelines, and enhancing access to PBS-listed medicines and Medicare services for diagnosis and treatment.
PBAC Proposes Expanding Endometriosis Treatments on PBS Despite Challenges in Access and Evidence
In response to PBAC’s request, a report comparing available therapies in Australia for endometriosis to Australian clinical guidelines was developed. It identified three medicines TGA registered for endometriosis currently listed on the PBS for specific use: Goserelin, Nafarelin, and Medroxyprogesterone acetate. Other treatments, including Dienogest and combinations such as Dienogest and estradiol valerate, along with NSAIDs, gonadotropin-releasing hormone (GnRH) analogs, and newer combined oral contraceptives, were proposed in addition to improving treatment access.
The stocktake revealed several barriers to accessing endometriosis treatments, such as a lack of training among health professionals for inserting hormonal devices and the limited motivation for pharmaceutical companies to pursue TGA registration and PBS listing. The PBAC, acknowledging stakeholder feedback, recognized the need for funding additional medicines like Dienogest and NSAIDs but also noted the lack of sufficient evidence for expanding PBS listings for other suggested treatments. It proposed further research to evaluate the effectiveness of these medicines in treating endometriosis.
Resource: Pharmaceutical Benefits Scheme, March 28, 2024
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