At its November meeting, the PBAC will look at whether the restrictions imposed on GLP-1 medicines have been effective in limiting their use to the intended population.
The RACGP has urged the Pharmaceutical Benefits Advisory Committee to minimise red tape around prescribing GLP-1 medicines for type 2 diabetes, warning that additional authority requirements would add to the administrative burden already facing GPs.
At its November meeting the PBAC will review the use of GLP-1 medicines for type 2 diabetes and assess whether restriction changes introduced on 1 June 2024 have been effective in limiting their use to the recommended population.
Those June 2024 changes were a response to a utilisation analysis on whether the medicines were being prescribed outside of the PBS restrictions.
They clarified that GLP-1 medicines were only subsidised for use in combination with either metformin, sulfonylurea or insulin, but not in combination with either a DPP4 inhibitor or an SGLT2 inhibitor.
While a continuation prescription for GLP-1s is “authority required (streamlined)”, initiation of GLP-1s is “authority required (telephone/electronic)”.
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In a submission to the committee, the RACGP said it supported the review but argued for streamlined authority arrangements.
“Authority arrangements that require additional telephone or online approval processes impose significant time costs on general practitioners and patients, reducing time available for clinical care,” the college wrote.
“When reviewing restriction settings, the RACGP encourages the PBAC to consider both the policy objectives of the restrictions and the practical impact of administering those requirements in primary care.
“While streamlined authority arrangements have less of an administrative burden compared with telephone or online approvals, GPs face considerable challenges choosing the appropriate indication when there are many approved indications available for a streamlined authority prescription.”
RACGP diabetes specific interest group chair Dr Gary Deed told The Medical Republic that, while changing the initiation authority requirement from telephone/electronic to streamlined would likely save GP’s time, the PBAC’s also had to guard against “unintended non-PBS authorised use”.
“It’s the startup process that does create administrative burden, but PBAC previously have utilised that to identify unintended prescribing combinations of GLP-1s and SGLT2s,” he said.
The RACGP also urged the PBAC to consider GLP-1 utilisation and cost-effectiveness within the wider context of diabetes management, including downstream costs and the potential for prescribing patterns to change as new therapies reach the market.
“Any cost saving in this area will allow the introduction of newer agents that might come for PBAC funding,” Dr Deed said.
“It’s about equity and importance of access because there’s a lot of emerging medications coming, and the pool of money isn’t exponential.
“We do have these systems that allow equitable and scientific analysis of prescribing to ensure people with diabetes get what’s currently available, but also what might be coming in the future.”
