NEWS 9
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NEWS 9
PBAC crackdown criticised
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Kemal Atlay A LOOMING PBS crackdown on GLP-1 receptor agonists is inconsistent with type 2 diabetes management guidelines and will force doctors to prescribe less efficacious drugs , says a leading endocrinologist .
Following its July meeting , the PBAC said subsidies for GLP-1 receptor agonists ( RAs ) should be restricted to patients with contraindications , intolerance or inadequate response to SGLT-2 inhibitors .
It also recommended an authority
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listing for initiating GLP-1 RAs but streamlined authority for continuing treatment .
However , Associate Professor Neale Cohen said this could lead to suboptimal treatment .
“ The SGLT-2 inhibitors are a very important class , … but to link [ prescribing of ] the two is not consistent with TGA approvals and not consistent with any guidelines ,” said the head of diabetes clinical research at the Baker Heart and Diabetes Institute in Melbourne . While SGLT-2 inhibitors were
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widely used and cheaper , Professor Cohen said GLP-1 RAs were “ clearly superior ” in terms of HbA1c reduction and weight loss .
The PBAC hinted at a potential , albeit limited , expansion of PBS criteria for GLP-1 RAs to include use in combination with metformin , a sulfonylurea or insulin for patients with a BMI > 35kg / m 2 but without the need to trial an SGLT-2 inhibitor .
Professor Cohen also criticised the PBAC for knocking back Eli Lilly ’ s application to list tirzepatide
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( Mounjaro ) on the PBS for adults with poorly controlled type 2 diabetes in combination with metformin .
The PBAC rejected the sponsor ’ s claim that the once-weekly drug was non-inferior in terms of safety and said the requested price would be “ extremely high ”.
Eli Lilly said it would still launch the drug on the private market and continue pushing for a PBS listing . Professor Cohen has received funding from Eli Lilly , Novo Nordisk and other diabetes drug manufacturers / sponsors .
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Associate Professor Neale Cohen . |
Registrars to miss out on $ 30k ?
Heather Saxena GP registrars who joined the training program in Victoria have been left fuming after learning they may miss out on an election promise of $ 30,000 top-up payments .
Ahead of the state election last year , Premier Dan Andrews unveiled his $ 32 million program “ to incentivise doctors to become GPs ” through cash payments to enrol in the specialty ’ s training program .
“ The package will deliver $ 30,000 top-up payments for first-year trainee GPs , ensuring they don ’ t take a significant pay cut to become a GP ,” Mr Andrews said at the time .
“ We will also cover the costs of their exams in their first year , investing $ 10,000 per trainee .”
Further details , including any eligibility criteria , have still not been released .
However , the AMA in Victoria said it had been told informally that the payments would only be offered to the 2024 and 2025 registrar cohorts , with those starting their training this year missing out .
“ Understandably , this development has elicited feelings of anger , confusion and disappointment ,” it said in a recent update .
“ These registrars reasonably relied upon the government ’ s clear commitment to funding and support as they embarked on their training journeys .”
AMA Victoria president Dr Jill Tomlinson said registrars were only finding out now because the government could not finalise the scheme until funding was confirmed in the state budget .
But she said she was hopeful its discussions with the government would see this year ’ s registrars receive the full funding that was promised .
“ The devil is all in the detail , but our discussions and advocacy with the government have been promising .”
PAXLOVID has provisional approval for the treatment of coronavirus disease 2019 ( COVID-19 ) in adults 18 years of age and older , who do not require initiation of supplemental oxygen due to COVID-19 and are at increased risk of progression to hospitalisation or death . 1
Before initiating PAXLOVID , patients will need to withhold treatment with any contraindicated medications where it is clinically appropriate to do so , and observe an appropriate washout period . 1
Standard dose of Paxlovid is 300 mg nirmatrelvir and 100 mg ritonavir tablets taken together orally every 12 hours for 5 days . Reduce dose to nirmatrelvir / ritonavir 150 mg / 100 mg every 12 hours for 5 days for patient with moderate renal impairment ( eGFR ≥30 to < 60 mL / min / 1.73m 2 ). 1
PBS information : Authority Required ( STREAMLINED ). Category : GENERAL - General Schedule ( Code GE ). For verified SARS-CoV-2 infection . Treatment must be initiated within 5 days of symptom onset . Refer to PBS Schedule for full authority information .
Reference : 1 . PAXLOVID Product Information .
© 2023 . Pfizer Australia Pty Ltd . Sydney , Australia . All rights reserved . This information is intended only for healthcare professionals . www . pfizer . com . au . Medical Information : 1800 675 229 . www . pfizermedicalinformation . com . au . PP-PAX-AUS-0580 . 07 / 23 . PFIZ4881 .
Gandhi MacIntyre PBS eligible ≥ 70 year old no risk factors required
I ’ M PRO FIGHTING COVID-19 I ’ M ANTI-VIRAL
BEFORE PRESCRIBING , PLEASE REVIEW FULL PRODUCT INFORMATION AVAILABLE BY SCANNING THE QR CODE OR VISITING https :// www . pfi . sr / paxlovid-pi
Warning : Nirmatrelvir with ritonavir has significant drug-drug interactions . Prescribers and dispensers should carefully review a patient ’ s concomitant medications .
This medicinal product is subject to additional monitoring in Australia . This will allow quick identification of new safety information . Healthcare professionals are asked to report any suspected adverse events at www . tga . gov . au / reporting-problems .
Alternatively , any adverse events which are experienced with PAXLOVID can be reported to Pfizer on 1800 675 229 or by email to AUS . AEReporting @ pfizer . com