The PBS has signalled a move to subsidise dual combination therapy for patients with pulmonary arterial hypertension (PAH).
A recommendation to subsidise combination therapy with an endothelin receptor antagonist (ERA) and phosphodiesterase-5 (PDE-5) inhibitor for patients with WHO Functional Class III and IV PAH was accepted by the Pharmaceutical Benefits Advisory Committee (PBAC) at its November 2018 meeting.
The move away from the current restriction to monotherapy for PAH patients is long overdue and will bring PBS subsidies some way towards alignment with evidence-based guidelines, according to Dr Edmund Lau, respiratory physician at the Royal Prince Alfred Hospital, Sydney.
He told the limbic that dual combination therapy had been the standard of care for most patients with PAH for about four to five years.
The lack of PBS subsidy means that patients with PAH currently had to purchase their medications for combination therapy on private prescription or rely on compassionate access programs, he said.
“I’m very pleased that the PBS will be funding combination therapy, at least for patients with class III and IV disease,” said Dr Lau.
However he noted that recent trials such as the AMBITION study had shown that patients with less severe disease – functional class II – had better outcomes with first-line combination therapy compared to monotherapy.