Cardiologists should soon have the option to use mortality-risk calculators, not just WHO criteria, to determine for PBS-listed therapies for pulmonary arterial hypertension, following a decision by the Pharmaceutical Benefits Advisory Committee (PBAC).

Outcome minutes from the May intracycle PBAC meeting showed that after a post-market review, the committee recommended incorporating risk assessment, or the risk of 1-year mortality using a validated risk calculator, as an additional option to using the WHO functional class status when deciding which patients can access subsidised treatment.

“The PBAC accepted that the investigations and clinical observations included in the various validated risk assessment calculators already occur in practice and that the incorporation of risk assessment into the PBS restrictions would bring further alignment of PBS restrictions with clinical practice and international treatment guidelines,” the committee said.

The change would have minimal financial impacts. The committee preferred a simplified structure to the restriction changes, pending consultation with experts on the best way forward.

Meanwhile, the committee recommended extending PBS listings for the majority of cardiovascular system medicines in ‘Tranche 1’ of the designated registered nurse prescribing program so that nurses can write these scripts.

Registered nurses would need to have a formal prescribing agreement with an authorised health practitioner, like a GP before they create prescriptions.

The PBAC also cleared the way for PBS listings of a variety of alimentary tract, genitourinary system and antiparasitic medicines also set to become available through nurse prescribing.

The committee also provided advice at the May meeting on pricing for migalastat for Fabry disease, adjusting risk-sharing expenditure caps.

Read the full list of PBAC meeting outcomes here.