Ponesimod approved for MS
Ponesimod (Ponvory) has received TGA approval for relapsing forms of multiple sclerosis (RMS).
The sphingosine 1 phosphate (S1P) receptor 1 modulator is approved for use in adult RMS patients “with active disease defined by clinical or imaging features”, according to the TGA decision summary, which notes that the drug binds relevant receptors on lymphocytes and prevents them leaving the lymph nodes, reducing their presence in peripheral blood.
“The mechanism by which ponesimod exerts therapeutic effects in multiple sclerosis may involve reduction of lymphocyte migration into the central nervous system,” the TGA website states.
Ponvory is an oral medication marketed by Janssen Cilag, with tablet dosages ranging from 2 mg to 20 mg.
Prescription costs eased with PBS Safety Net changes
Patients with chronic diseases will have the financial burden for medication costs eased by an announcement of the lowering of PBS safety net thresholds in the 2022 Budget.
From July 1 the threshold for access for general patients will be lowered by the equivalent of two scripts, from $1,542.10 to $1,457.10, a saving of up to $85. This means that after the equivalent of about 34 full-priced general co-payments, general patients pay only the concessional co-payment of $6.80 per PBS script for the balance of the year.
For concession card holders, the threshold will be reduced by the equivalent of 12 scripts from $326.40 to $244.80, a saving of up to $81.60. When concession card holders reach the safety net threshold, after 36 full-priced concessional scripts, they will receive PBS medicines at no charge for the balance of the year.
The measure is costing $525.3 million over four years from 2022–23.
Aboriginal and Torres Strait Islander all-cause concussion data lacking
A lack of data on all-cause concussion in Aboriginal and Torres Strait Islander peoples may impede diagnosis and management and should be rectified with culturally appropriate studies, Australian researchers say.
Published in The MJA, their article states that “Aboriginal and Torres Strait Islander peoples are 1.7 times more likely to sustain a [traumatic brain injury] than the general population”, yet comprehensive epidemiological data is wanting.
Most concussion-related data have been collected from hospitalisations and failed to capture Aboriginal and Torres Strait Islander peoples who went to hospital but had their signs or symptoms overlooked or weren’t assessed due to prolonged waiting times or a lack of cultural awareness at first point of contact; presented to Aboriginal Community Controlled Health Organisations (ACCHO) or primary care; or didn’t present after a potential concussion episode at all.
The resulting knowledge gaps and holes in culturally-safe health care outside the ACCHO setting “may result in inaccurate or misdiagnosis of cognitive or anxiety/mood subtypes of concussion due to westernised assumptions of normal”, the authors wrote.
“In the case of trauma, where multiple injuries have occurred, concussion may not be the primary diagnosis and may be overlooked despite presentation to the emergency department.”
The authors questioned the usefulness of diagnostic tools such as the Sport Concussion Assessment Tool, fifth edition, which “is often used in sports-related concussion assessment but has no evidence of being culturally appropriate for Aboriginal or Torres Strait Islander peoples, especially for those who do not speak English as a first language”.
Culturally appropriate research is needed to clarify the incidence and prevalence of concussion in Aboriginal and Torres Strait Islander peoples, along with their knowledge, needs and experiences with concussion injury, factors preventing presentation for medical assessment and ways to improve care for this population, the authors concluded.