News in Brief: Selexipag on PBS; IHD rates decline; Active ingredient prescribing

Selexipag listed on PBS for PAH

The oral therapy selexipag (Uptravi) is available on the PBS from 1 February for the treatment of people with pulmonary artery hypertension (PAH) as combination therapy. The selective, prostacyclin receptor agonist is indicated as sequential add-on therapy in combination with an endothelin receptor antagonist (ERA) and/or phosphodiesterase type 5 inhibitor (PDE-5i) for patients with WHO Functional Class III or IV PAH. The listing was recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) in July 2020, on the basis that selexipag would help overcome the limitations of daily activities and impaired quality of life with PAH, and especially avoid or reduce those associated with IV infusion of epoprostenol.

IHD rates decline but rural areas still disadvantaged

Ischaemic heart disease hospitalisations and mortality have declined considerably in Australia over the last 15 years, but inequalities persist between urban and rural regions, a new study shows. The rate of IHD hospitalisations fell by 5.6% per year in urban areas and by 4.5% a year in rural hospitals between 2001 and 2015, according to a study carried out by the Sydney University School of Public Health. IHD mortality rates at a similar rate in urban and rural regions (-7.6% vs -6.7% per year). However inequalities remained in the absolute numbers of IHD deaths which stood at 49 per 100,000 people for urban areas and 70/100,00 for rural IHD deaths.

Generic prescribing now the rule

New PBS rules requires medicines to be prescribed by active ingredient name rather than by brand name, except for a few exemptions. From 1 February, the Active Ingredient Prescribing policy requires the inclusion of active ingredients on all PBS and RPBS prescriptions, except for handwritten prescriptions; paper based medication charts in the residential aged care sector; products containing four or more active ingredients; and certain items where brand names should be specified for safety or practicality reasons – such as EpiPens. The exempt items are listed on the List of Medicines for Brand Consideration. The Department of Health says prescribers can still prescribe medicines by brand if clinically necessary, and the brand name will appear after the active ingredient. A prescriber may also still choose to disallow brand substitution. The changes will be incorporated into prescribing software but this cannot be set to automatically include brand names for every prescription.

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