New updates to the Pharmaceutical Benefits Scheme (PBS) announced as parliament begins debate on general co-payment legislation.
From 1 October 2022, Australians who suffer from migraines, psoriatic arthritis, stomach ulcers and bipolar disorder will pay less at the pharmacy for more than 2,000 brands of new and updated medicines, saving more than $130 million for patients and almost $930 million for taxpayers.
The announcement on Monday 26 September came just before the House of Representatives commenced debate on the Government’s National Health Amendment (General Co-payment) Bill 2022, which proposes the biggest cut to the cost of medicines for Australian households in the 75-year history of the PBS – around 30% for general patients.
At the time of writing the bill is still before the House.
Federal Minister for Health and Aged Care, Mark Butler, said the proposal will cut the cost of medications for millions of Australians by reducing the PBS co-payment from the current maximum of $42.50 per script, to a maximum of $30 per script from 1 January 2023.
“This is not just a great thing for the hip pockets of millions of Australian patients, it’s also good for their health: the Australian Bureau of Statistics (ABS) has told us that as many as 900,000 Australians every single year are choosing to go without medicines that their doctor has prescribed for their health,” Minister Butler said.
“I’m also very pleased to announce that from this Saturday (1 October 2022) there will be a cut in price to more than 2,000 brands of medicines on the PBS.
“Those brands of medicines include very commonly used medicines right across the Australian community [and] listing these drugs on the PBS will improve the lives of thousands of Australian patients and their families.”
- More than 20,000 migraine sufferers and people with epilepsy can now expect to pay $34.90 per script for topiramate 200 mg tablets, a saving of up to $6.63.
- Around 15,000 patients suffering from severe psoriatic arthritis and prescribed leflunomide 20 mg tablets can expect to pay $37.19 per script, a saving of up to $5.31 per script.
- Up to half a million patients with stomach ulcers or gastroesophageal reflux disease will now pay $26.74 per script for esomeprazole 40 mg tablets, a saving of up to $6.84 per script.
- For over 60,000 patients with schizophrenia or bipolar disorder, scripts for quetiapine 200 mg tablets will cost $28.42, a saving of up to $6.22 per script.
- Scripts for the antiepileptic drug lamotrigine 200 mg tablets will also be added to the PBS, set to cost $33.45, which represents a saving of up to $4.66.
The Government will also list additional medicines to treat several types of cancer, including the immunotherapy drug pembrolizumab (Keytruda), which will be expanded to treat patients with squamous cell carcinoma of the head and neck.
It is estimated that around 5,100 Australians will be diagnosed with head and neck cancer (including lip cancer) in 2022 and without any subsidy, patients could pay more than $135,000 per course of treatment.
Minister Butler noted that nearly 500 patients would benefit each year from this one expansion alone.
“Because of the listing of that medicine, or the extension of the listing of that therapy for head and neck cancers, those patients will now pay $42.50 for every script,” he said
“And if our legislation passes from the first of January will just pay $30 per script.”
Other cancer treatments have also been added to the list:
- Almost 13,000 women using anastrozole to inhibit the progression of breast cancer will save up to $2.36 per script, at $22.07 per script for a 1 mg tablet.
- Avelumab (Bavencio) will also be expanded as maintenance treatment for locally advanced (Stage III) or metastatic (Stage IV) urothelial carcinoma, a move set to benefit some 400 bladder cancer patients who would otherwise pay more than $106,000 per course of treatment.
- Decitabine with cedazuridine (Inqovi®) (originally more than $43,500 per course of treatment) will list for the first time on the PBS to treat some 1,000 Australians with myelodysplastic syndromes (MDS) or chronic myelomonocytic leukaemia (CMML).
The Government will also list mecasermin (Increlex®) for the first time to treat children with primary insulin-like growth factor 1 deficiency (Primary IGFD), whose height is impacted by low production of the insulin-like growth factor-1 (IGF-1).
Without subsidy, the families of the 80 Australian children impacted faced costs of up to $40,500 per year for mecasermin, the synthetic form of IGF-1, but through the PBS, these treatments will cost just $42.50 per script, or $6.80 with a concession card.