News in brief: Triple therapy listed on PBS for severe asthma; Prescription costs eased with PBS Safety Net changes; CALD communities resistant to pulmonary rehab 

Thursday, 7 Apr 2022

Triple therapy listed on PBS for severe asthma

The single inhaler triple therapy Trelegy Ellipta has been listed on the PBS from 1 April for maintenance therapy of severe asthma.

The PBAC recommended the combination of fluticasone furoate 200 mcg with umeclidinium 62.5 mcg and vilanterol 25 mcg for the Authority Required (STREAMLINED) listing at its November 2021 meeting.

“The PBAC considered the claim of non-inferior effectiveness and safety to the FDC of mometasone furoate (MF) 136 mcg, with indacaterol (IND) 114 mcg and glycopyrronium (GLY) 46 mcg was reasonable.”

“The PBAC considered for purposes of satisfying Section 101(3B) of the National Health Act 1953, any high dose inhaled corticosteroid (ICS) with long-acting beta2-agonist (LABA) + tiotropium (TIO) combination are relevant alternative therapies.”

Respiratory physician Professor Greg King said that having access to a new therapeutic option was important for Australians with severe asthma.

Patients must have experienced at least one severe asthma exacerbation in the 12 months prior to having first commenced treatment for severe asthma, which required systemic corticosteroid treatment despite each of: (i) receiving optimised asthma therapy, (ii) being assessed for adherence to therapy, (iii) being assessed for correct inhaler technique.

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.

CALD communities resistant to pulmonary rehab 

People with COPD have poor engagement with pulmonary rehab services, especially those from from culturally and linguistically diverse (CALD) communities, Victorian research shows.

A study of 97 attendees at COPD clinics found that 37% were from CALD communities and they were 2.6 times less likely to have heard about pulmonary rehab as compared with people from non-CALD communities.

Engagement rates for pulmonary rehab were low across all groups, with only half of those referred attending the programs and only 11% of participants completing it. Low English proficiency, old age and low household income were significant factors in poor engagement.

Attendance at the respiratory clinic was the linchpin to referring, attending and completion of pulmonary rehab, the researchers said, with the findings also highlighting the need for clinicians to initiate a conversation about rehab programs with COPD patients, they added.

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