Proposed PBS changes would broaden access to two non-stimulant ADHD medicines and allow more doctors to initiate treatment.
The Pharmaceutical Benefits Advisory Committee has backed changes to PBS restrictions for two non-stimulant ADHD medicines, potentially expanding treatment access and removing specialist-only initiation requirements.
The recommendations, made at the PBAC’s September 2026 meeting, would broaden subsidised access to atomoxetine and guanfacine for patients who have not responded adequately to stimulant treatment or for whom stimulants are clinically inappropriate.
The committee also recommended expanding the range of authorised prescribers beyond specialists for treatment initiation, in a move intended to better align PBS restrictions with contemporary Australian clinical guidelines.
“This work partially addresses recommendations from 2023 Senate Community Affairs References Committee inquiry into ADHD, with a further tranche to follow on the PBS-listing stimulants for ADHD,” the PBAC said in its September meeting outcomes report.
Under the proposed changes, patients who have tolerated stimulant medication but experienced an inadequate treatment response would become eligible for PBS-subsidised atomoxetine or guanfacine.
The medicines would remain second-line treatment options, with the PBAC supporting broader access rather than a shift towards their use as first-line therapies.
The committee said the recommendations were informed by advice from its Drug Utilisation Sub-Committee, stakeholder feedback, and issues raised during the Senate inquiry.
It also considered revised modelling of the potential financial impact of expanding access.
The PBAC noted that estimated utilisation and expenditure were substantially higher than previously forecast using a private-market-share approach, with uncertainty remaining around the size of the untreated ADHD population.
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Although cost-effectiveness had not been formally established for the expanded patient population, the committee considered the proposed changes likely to represent acceptable value for money.
The PBAC recommended ongoing monitoring of medicine utilisation and prescribing patterns following implementation.
The recommendations represent the first tranche of a broader review of ADHD medicines, with further consideration of PBS-listed stimulant treatments to follow.
The committee said the changes were intended to improve alignment between PBS access and current Australian clinical guidelines while maintaining atomoxetine and guanfacine as second-line options.
The published outcomes did not specify which additional prescriber groups would become eligible to initiate treatment or provide an implementation date. It is expected this would become clearer if the recommendation is accepted by the PBS.
The recommendations are subject to the usual government processes before any changes to PBS restrictions take effect.
