Rituximab recommended for unrestricted PBS listing

Rituximab and liposomal doxorubicin may soon have an unrestricted benefit listing on the PBS following a recommendation from the Pharmaceutical Benefits Advisory Committee.

At its September meeting the PBAC recommended that following numerous requests the PBS listings for all listed brands of rituximab be changed to Unrestricted Benefit listings. In making its decision, the PBAC said it considered that changing the rituximab listings to unrestricted would provide subsidised access to treatment for patients with conditions where there are no alternative PBS listed medicines.

And following the delisting of the reference brand of rituximab IV, MabThera, the PBAC recommended removal of the administrative notes related to the biosimilar uptake drivers for biosimilar brands such as Riximyo and Truxima.

For doxorubicin, the PBAC considered that a potential benefit of an unrestricted listing would be improved access for patients with rare sarcomas, endometrial cancer, and frail patients unable to tolerate standard treatment.

The PBAC recommendations are subject to approval by the Federal minister for health

Multiple myeloma context for Colin Powell death

The death of former US secretary of state Colin Powell from COVID-19 despite being fully vaccinated has to be seen in context of his receiving treatment for multiple myeloma, his family have said.

In a statement, the family said Mr Powell, 84 was being treated for the blood cancer at Walter Reed National Medical Center and had received his second dose of the Pfizer-BioNTech vaccine in February and was due to receive a third. Mr Powell’s aide Peggy Cifrino told the Washington Post that he was immunocompromised as a result of his multiple myeloma, had been successfully treated for cancer for two or three years.

“Obviously it was a factor with his compromised immune system when he got the covid,” she said.

Many media reports focused on the fact that Mr Powell had died of covid complications despite being fully vaccinated, but the family statement said they wanted to encourage everyone to get vaccinated.

The Post cited haematologists and infectious disease physicians saying that multiple myeloma would impair immune protection to covid vaccination, particularly B cells responses.

“Bottom line, he had an unfortunate, specific type of malignancy. He was at high risk not only for covid but a lot of different infections,” said Dr Albert Ko, an infectious-disease physician at the Yale Schools of Public Health and Medicine.

AMA calls for healthcare staff to receive boosters

The AMA has urged immunisation advisers to provide recommendations for COVID-19 booster doses for healthcare professionals.

AMA Victorian president Dr Rod McRae said the Australian Technical Advisory Group on Immunisation (ATAGI) should consider whether immunity may already be waning for medical staff who had their primary course of vaccinations at the start of the year.

“They should be looking after healthcare workers to ensure that they’re as protected as they possibly can be as they have made the decision to open up the community,” he said.

However Professor Robert Booy of the  National Centre for Immunisation Research and Surveillance (NCIRS) said there was no need to panic as evidence from overseas showed protection against the virus remained strong even if markers of immunity appeared to be waning.

“I’ve been doing vaccine research for over 30 years. I always see a decline in antibody at six to 12 months. That’s normal,” he said.

“If you’re a standard, run of the mill person who is reasonably healthy you retain immunity – and that’s after six to 12 months,” he said.

Professor Booy told the Nine Network that a booster would probably be delivered in after March 2022 at the same time as a flu jab.